Near-infrared Fluorescence Research Articles

Robot-assisted Surgery for Gastrointestinal Cancer Using Indocyanine Green Conjugated Endoscopic Marking Clip Under Firefly Fluorescence Imaging.

Intraoperative identification of the cancer location is often difficult during robot-assisted surgery, especially in early stage cancers. This study aimed to investigate the feasibility and accuracy of a novel endoscopic clip emitting near-infrared (NIR) fluorescence during robot-assisted surgery for gastrointestinal cancer. Preoperative placement of endoscopic marking clips equipped with NIR fluorescent resin was performed to determine the resection margins in six patients with gastrointestinal cancer. During robot-assisted surgery, a NIR fluorescence imaging system was used to detect the fluorescence. The evaluation examined whether fluorescence from the clips was visualized during robot-assisted surgery. The NIR fluorescent signals emitted from the clips were successfully detected in all six patients from the serosal surfaces, resulting in the quick and accurate identification of the resection line. There were no significant differences in age, sex, or body mass index between the patients in whom we could detect NIR fluorescence. This novel NIR fluorescent clip is a promising diagnostic tool for accurately detecting tumor locations during robot-assisted surgery for gastrointestinal cancer.

Near-infrared fluorescence clip guided robot-assisted minimally invasive esophagectomy for esophagogastric junction cancer: a case report

BackgroundAlthough treatment strategy differs between countries, surgery remain the mainstay of treatment for localized esophagogastric junction cancer. Tumor proximal margin is one of the critical factors to achieve curative resection during esophagogastric junction cancer surgery. Thus, an accurate preoperative marking of the tumor is essential, however, accuracy of conventional methods was highly dependent upon endoscopists skills. Here, we present a case of a patient with locally advanced Siewert type II esophagogastric junction cancer treated by robot-assisted minimally invasive esophagectomy utilizing near-infrared fluorescence clip as a novel marking method.Case presentationA male patient in his 70 s was diagnosed as having cT3N1M1 esophagogastric junction cancer and was treated by immunochemotherapy followed by surgery. Near-infrared fluorescence marking clips were placed 2 cm above the tumor proximal end under endoscopy prior to surgery. Location of the clips were confirmed by fluorescence imaging during robotic surgery, and the esophagus was dissected by a surgical stapler without intraoperative endoscopy. Histopathologically, the tumor was diagnosed as ypT2N0M0, with negative margins.ConclusionsNear-infrared fluorescence clip may enable easy, safe, and an accurate preoperative marking, and may be considered during endoscopic surgeries.

Harnessing native-cryptic plasmids for stable overexpression of heterologous genes in Clostridium butyricum DSM 10702 for industrial and medical applications

Clostridium butyricum has emerged as a promising candidate for both industrial and medical biotechnologies, underscoring the key pursuit of stable gene overexpression in engineering C. butyricum. Unlike antibiotic-selective vectors, native-cryptic plasmids can be utilized for antibiotic-free expression systems in bacteria but have not been effectively exploited in C. butyricum to date. This study focuses on leveraging these plasmids, pCB101 and pCB102, in C. butyricum DSM10702 for stable gene overexpression without antibiotic selection via efficient gene integration using the SacB-based allelic exchange method. Integration of reporter IFP2.0 and glucuronidase generated sustained near-infrared fluorescence and robust enzyme activity across successive subcultures. Furthermore, successful secretion of a cellulase, Cel9M, and the human interleukin 10 from pCB102 highlights native-cryptic plasmids’ potential in conferring stable gene products for industrial and medical applications in C. butyricum. This work appears to be the first study to harness the Clostridium native-cryptic plasmid for stable gene overexpression without antibiotics, thereby advancing the biotechnological prospects of C. butyricum.

Biomimetic Gd-Metal-Organic Framework Radiosensitizer for Near-Infrared Fluorescence Imaging-Guided Radiotherapy toward Nasopharyngeal Carcinoma.

Radiotherapy (RT) is recognized as a primary treatment modality for Nasopharyngeal carcinoma (NPC). However, enhancing RT's targeting accuracy and selectivity remains a significant challenge. In this study, we present an innovative radiosensitizer, Gd-metal-organic framework (MOF)-based nanocarrier coated with indocyanine green (ICG) and red blood cell membrane (RBCM), designed to bypass immune clearance and achieve prolonged circulation within the bloodstream. This design significantly enhances tumor localization and systemic circulation, as evidenced by in vivo analyses. The strategic accumulation of the Gd-MOF-ICG nanocarrier at the tumor site facilitates precise tumor localization and sensitization to RT, leveraging the RBCM camouflage to enhance the tumor uptake potential. Our comprehensive study introduces a potent approach for optimizing RT in NPC treatment through this advanced theranostic nanoplatform, which combines material science with biomedical engineering to augment the effectiveness of RT and underscores the significance of precision in cancer therapy. This strategy offers a promising avenue for clinical application and further research in targeted cancer treatments.

Impact of indocyanine green on decision making for performing laparoscopic cortical sparing adrenalectomy.

Indocyanine green imaging (ICG) is an expansion technology that can contribute to the development of demanding techniques such as cortical-sparing adrenalectomy (CSA). The aim of this study was to determine in which cases CSA should be performed and when total adrenalectomy should be performed instead based on ICG fluorescence. Here, we present our experience through a series of cases and videos. Prospective and descriptive study on patients with surgical adrenal lesions who were proposed for CSA using ICG with near-infrared fluorescence imaging in our center. A first bolus of 6,25mg ICG was administered intravenously upon exposure of the retroperitoneal plane. Fluorescence was visualized using a Storz® NIR/ICG endoscopic system. Seven patients were proposed for CSA. After the application of ICG, a change in attitude was carried out in 71.4% of the cases (five of seven). In the two patients in whom CSA could be performed, the adrenal remnants were functional, and the resection margins of the surgical specimens were free of disease. The reasons why partial adrenalectomy could not be completed, and a total adrenalectomy was decided instead were the presence of a tumor located very close to the adrenal vein that prevented a correct remnant volume (n = 4) and one case of isofluorescent tumor with the adrenal parenchyma. ICG fluorescence guidance could help in the decision making to select patients intraoperatively for successful cortical preservation.

Impact of Infrared Indocyanine Green Fluorescence imaging-guided Laparoscopic Hepatectomy on Securing the Resection Margin for Colorectal Liver Metastasis.

Laparoscopic hepatectomy for colorectal liver metastases (CRLM) is performed worldwide. However, owing to a lack of palpatory information and difficulties associated with accurate intraoperative ultrasonographic diagnosis, the tumor may be exposed at the hepatic transection margin. This study aimed to investigate the pathological significance of near-infrared (NIR) fluorescence imaging with indocyanine green (ICG)-guided laparoscopic hepatectomy and determine its usefulness in securing the resection margin for CRLMs. Fifty-nine patients who underwent laparoscopic hepatectomy for CRLM using NIR fluorescence imaging between February 2017 and June 2021 at Sapporo Medical University Hospital were included. Generally, all patients received intravenous ICG (2.5mg/body) as a fluorescence agent 1 to 2 days before surgery. During the surgical procedure, real-time NIR fluorescence imaging was repeatedly performed to assess the surgical margins. Of the 94 tumors in 59 patients, laparoscopic NIR fluorescence imaging identified 56 tumors (59.6%) on the liver surface. Pathological analysis indicated clear margins in 96.6% (57/59) of patients. Examination of paraffin-embedded sections, which were successful in only 20 of 94 cases (21.3%), revealed that there were no tumor cells positive for NIR fluorescence, and the median distance of the continuous fluorescent signal from the tumor margin was 1.074mm. We demonstrated a high R0 rate using NIR fluorescence-guided hepatectomy. This technique has the potential to improve intraoperative tumor identification and tumor margin assurance and reduce the rate of positive resection margins in patients with CRLMs.

The Aggregation Units of J-Aggregates: Transitioning from Monomers to Hydrogen-Bonded Dimers.

In recent years, J-aggregates, as supramolecular assembly structures, have increasingly attracted scientific interest. Currently, the prevailing consensus is that J-aggregates are formed through the interleaved stacking of monomers arranged in parallel. However, our findings suggest that the fundamental units constituting J-aggregates are not limited to monomers alone but also encompass molecular aggregates interconnected by noncovalent bonds, which we designate as aggregation units. We have synthesized three asymmetric pyrrolopyrrole cyanine (PPCy) dyes capable of forming hydrogen-bonded dimers and have verified that these hydrogen-bonded dimers can serve as aggregation units to generate J-aggregates. The detailed structural and optical properties revealed that the J-aggregates of these dyes exhibited a significantly red-shifted and narrowed emission in the near-infrared (NIR) fluorescence compared to the monomers.

Fluorescence and photoacoustic (FL/PA) dual-modal probe: Responsive to reactive oxygen species (ROS) for atherosclerotic plaque imaging

Accurate and early detection of atherosclerosis (AS) is imperative for their effective treatment. However, fluorescence probes for efficient diagnosis of AS often encounter insufficient deep tissue penetration, which hinders the reliable assessment of plaque vulnerability. In this work, a reactive oxygen species (ROS) activated near-infrared (NIR) fluorescence and photoacoustic (FL/PA) dual model probe TPA-QO-B is developed by conjugating two chromophores (TPA-QI and O–OH) and ROS-specific group phenylboronic acid ester. The incorporation of ROS-specific group not only induces blue shift in absorbance, but also inhibits the ICT process of TPA-QO-OH, resulting an ignorable initial FL/PA signal. ROS triggers the convertion of TPA-QO-B to TPA-QO-OH, resulting in the concurrent amplification of FL/PA signal. The exceptional selectivity of TPA-QO-B towards ROS makes it effectively distinguish AS mice from the healthy. The NIR emission can achieve a tissue penetration imaging depth of 0.3 cm. Moreover, its PA775 signal possesses the capability to penetrate tissues up to a thickness of 0.8 cm, ensuring deep in vivo imaging of AS model mice in early stage. The ROS-triggered FL/PA dual signal amplification strategy improves the accuracy and addresses the deep tissue penetration problem simultaneously, providing a promising tool for in vivo tracking biomarkers in life science and preclinical applications.

Near-infrared fluorescent probe for visualizing Se4+ and Zn2+ inhibition of Hg2+ uptake in plants and cell imaging

The advancement of industrialization has resulted in a significant influx of heavy metal ions into the ecological environment. Among these, the impact of Hg2+ on both plant growth and human health has garnered widespread attention. Therefore, it is imperative to address the removal of Hg2+ from the ecological environment. Here, our team has developed a near-infrared fluorescence probe, SN-Hg, for the detection of Hg2+. This probe offers several advantages including excellent selectivity, high sensitivity (LOD=85 nM), rapid response time and naked eye visualization. In addition, SN-Hg was successfully used to image the cells and the roots of plant (Platycodon grandiflorum seedlings) in situ. Moreover, the SN-Hg enabled 3D imaging of Hg2+ distribution in plants with a penetration depth of 80 μm. More importantly, the inhibitory effects of Se4+ and Zn2+ on the uptake of Hg2+ in Platycodon grandiflorum were further verified by SN-Hg. This study provides a foundation for soil protection and plant growth, as well as offering a new perspective for the removal of heavy metal pairs in ecological environments.

Imaging of intracellular mitochondrial membrane potential with a highly photostable NIR fluorescent probe

Mitochondrial membrane potential (ΔΨm) participated in important physiological processes such as ATP synthesis, ion exchange, and plays an important role in maintaining normal life activities of cells. Herein, we synthesized a fluorescent probe EDXB (3-ethyl-2-(2-(6-methoxy-2,3-dihydro-1H-xanthen-4-yl) vinyl) benzothiazol-3-ium iodide) with positive charge, which targets mitochondria by electrostatic attraction. The probe has twisted intramolecular charge transfer (TICT) characteristics, resulting in near-infrared fluorescence emission enhanced with the increase of viscosity, when the probe falls off from the mitochondrial membrane to the low-viscosity cytoplasmic aqueous phase, the fluorescence emission intensity is weakened. Therefore, the EDXB exhibited favorable targeting. In addition, EDXB also has good anti-bleaching and pH stability, which enables it to accurately feedback the change of ΔΨm. In the experiment, the intracellular imaging of EDXB certificated mitochondrial depolarization (decrease of ΔΨm) during various cell injury events including cell inflammation, apoptosis and mitophagy. We expect EDXB to be a useful tool for the analysis of ΔΨm changes.

Neutrophil-Targeting Semiconducting Polymer Nanotheranostics for NIR-II Fluorescence Imaging-Guided Photothermal-NO-Immunotherapy of Orthotopic Glioblastoma.

Glioblastoma (GBM) is one of the deadliest primary brain tumors, but its diagnosis and curative therapy still remain a big challenge. Herein, neutrophil-targeting semiconducting polymer nanotheranostics (SSPNiNO) is reported for second near-infrared (NIR-II) fluorescence imaging-guided trimodal therapy of orthotopic glioblastoma in mouse models. The SSPNiNO are formed based on two semiconducting polymers acting as NIR-II fluorescence probe as well as photothermal conversion agent, respectively. A thermal-responsive nitric oxide (NO) donor and an adenosine 2A receptor (A2AR) inhibitor are co-integrated into SSPNiNO to enable trimodal therapeutic actions. SSPNiNO are surface attached with a neutrophil-targeting ligand to mediate their effective delivery into orthotopic GBM sites via a "Trojan Horse" manner, enabling high-sensitive NIR-II fluorescence imaging. Upon NIR-II light illumination, SSPNiNO effectively generates heat via NIR-II photothermal effect, which not only kills tumor cells and induces immunogenic cell death (ICD), but also triggers controlled NO release to strengthen tumor ICD. Additionally, the encapsulated A2AR inhibitor can modulate immunosuppressive tumor microenvironment by blocking adenosine-A2AR pathway, which further boosts the antitumor immunological effect to observably suppress the orthotopic GBM progression. This study can provide a multifunctional theranostic nanoplatform with cumulative therapeutic actions for NIR-II fluorescence imaging-guided effective GBM treatment.

A Multimodal Protocol Combining 99mTc-Tilmanocept with Indocyanine Green Fluorescence Lympho-Angiography for Sentinel Lymph Node Biopsy in Early-Stage Oral Cancer: A Case Series.

Sentinel lymph node biopsy (SLNB) is currently considered as a viable alternative to elective neck dissection (END) for the management of cN0 oral cavity squamous cell carcinoma (OCSCC). However, some difficulties were detected in sentinel lymph node (SLN) identification in floor of mouth (FOM) and ventral tongue tumors because of the so-called "shine-through radioactivity" of the injection site, which may mask nodal hotspots in proximity. We assessed the feasibility and the potential strengths of combining 99mTc-Tilmanocept with indocyanine green (ICG) fluorescence lympho-angiography in a dedicated multimodal protocol for SLNB in T1/T2N0 oral cancer to evaluate the synergistic role of each of these two tracers in providing the appropriate sensitivity and ease of learning, even in such a critical anatomical subsite. A detailed, stepwise description of our multimodal protocol is provided, together with the presentation of its application in two cases of early-stage ventral tongue tumors. Radioactive guidance with 99mTc-Tilmanocept was used preoperatively to perform planar lymphoscintigraphy and single-photon emission computed tomography/computed tomography and to define the nodal hotspot(s) and the surgical "roadmap". In addition, it was used intraoperatively to pinpoint the SLN location within each nodal hotspot with high specificity but limited spatial resolution. Optical guidance with ICG injection at the tumor bed and near-infrared fluorescence imaging was then added, providing intuitive intraoperative guidance within each nodal hotspot with high spatial resolution. Our small experience with this protocol is illustrated and future perspectives are highlighted.

A novel BN aromatic module modified near-infrared fluorescent probe for monitoring carbon monoxide-releasing molecule CORM-3 in living cells and animals

Carbon monoxide (CO), a significant gas transmitter, plays a vital role in the intricate functioning of living systems and is intimately linked to a variety of physiological and pathological processes. To comprehensively investigate CO within biological system, researchers have widely adopted CORM-3, a compound capable of releasing CO, which serves as a surrogate for CO. It aids in elucidating the physiological and pathological effects of CO within living organisms and can be employed as a therapeutic drug molecule. Therefore, the pivotal role of CORM-3 necessitates the development of effective probes that can facilitate the visualization and tracking of CORM-3 in living systems. However, creating fluorescent probes for real-time imaging of CORM-3 in living species has proven to be a persisting challenge that arises from factors such as background interference, light scattering and photoactivation. Herein, the BNDN fluorescent probe, a brand-new near-infrared is proposed. Remarkably, the BNDN probe offers several noteworthy advantages, including a substantial Stokes shift (201 nm), heightened sensitivity, exceptional selectivity, and an exceedingly low CORM-3 detection limit (0.7 ppb). Furthermore, the underlying sensing mechanism has been meticulously examined, revealing a process that revives the fluorophore by reducing the complex Cu2+ to Cu+. This distinctive NIR fluorescence “turn-on” character, coupled with its larger Stokes shift, holds great promise for achieving high resolution imaging. Most impressively, this innovative probe has demonstrated its efficacy in detecting exogenous CORM-3 in living animal. It is important to underscore that these endeavors mark a rare instance of a near-infrared probes successfully detecting exogenous CORM-3 in vivo. These exceptional outcomes highlighted the potential of BNDN as a highly promising new tool for in vivo detection of CORM-3. Considering the impressive imaging capabilities demonstrated by BNDN presented in this study, we anticipate that this tool may offer a compelling avenue for shedding light on the roles of CO in future research endeavors.

Machine Learning-Assisted Near-Infrared Spectral Fingerprinting for Macrophage Phenotyping.

Spectral fingerprinting has emerged as a powerful tool that is adept at identifying chemical compounds and deciphering complex interactions within cells and engineered nanomaterials. Using near-infrared (NIR) fluorescence spectral fingerprinting coupled with machine learning techniques, we uncover complex interactions between DNA-functionalized single-walled carbon nanotubes (DNA-SWCNTs) and live macrophage cells, enabling in situ phenotype discrimination. Utilizing Raman microscopy, we showcase statistically higher DNA-SWCNT uptake and a significantly lower defect ratio in M1 macrophages compared to M2 and naive phenotypes. NIR fluorescence data also indicate that distinctive intraendosomal environments of these cell types give rise to significant differences in many optical features, such as emission peak intensities, center wavelengths, and peak intensity ratios. Such features serve as distinctive markers for identifying different macrophage phenotypes. We further use a support vector machine (SVM) model trained on SWCNT fluorescence data to identify M1 and M2 macrophages, achieving an impressive accuracy of >95%. Finally, we observe that the stability of DNA-SWCNT complexes, influenced by DNA sequence length, is a crucial consideration for applications, such as cell phenotyping or mapping intraendosomal microenvironments using AI techniques. Our findings suggest that shorter DNA-sequences like GT6 give rise to more improved model accuracy (>87%) due to increased active interactions of SWCNTs with biomolecules in the endosomal microenvironment. Implications of this research extend to the development of nanomaterial-based platforms for cellular identification, holding promise for potential applications in real time monitoring of in vivo cellular differentiation.

Multimodal Imaging-Assisted Intravascular Theranostic Photoactivation on Atherosclerotic Plaque.

Atherosclerosis is a chronic inflammatory disease causing a fatal plaque rupture, and its key aspect is a failure to resolve inflammation. We hypothesize that macrophage-targeted near-infrared fluorescence emitting photoactivation could simultaneously assess macrophage/lipid-rich plaques in vivo and facilitate inflammation resolution. We fabricated a Dectin-1-targeted photoactivatable theranostic agent through the chemical conjugation of the near-infrared fluorescence-emitting photosensitizer chlorin e6 and the Dectin-1 ligand laminarin (laminarin-chlorin e6 [LAM-Ce6]). Intravascular photoactivation by a customized fiber-based diffuser after administration of LAM-Ce6 effectively reduced inflammation in the targeted plaques of atherosclerotic rabbits in vivo as serially assessed by dual-modal optical coherence tomography-near-infrared fluorescence structural-molecular catheter imaging after 4 weeks. The number of apoptotic macrophages peaked at 1 day after laser irradiation and then resolved until 4 weeks. Autophagy was strongly augmented 1 hour after the light therapy, with the formation of autophagolysosomes. LAM-Ce6 photoactivation increased the terminal deoxynucleotidyl transferase dUTP (deoxyuridine triphosphate) nick end labeling/RAM11 (rabbit monocyte/macrophage antibody)- and MerTK (c-Mer tyrosine kinase)-positive cells in the plaques, suggesting enhanced efferocytosis. In line with inflammation resolution, photoactivation reduced the plaque burden through fibrotic replacement via the TGF (transforming growth factor)-β/CTGF (connective tissue growth factor) pathway. Optical coherence tomography-near-infrared fluorescence imaging-guided macrophage Dectin-1-targetable photoactivation could induce the transition of macrophage/lipid-rich plaques into collagen-rich lesions through autophagy-mediated inflammation resolution and TGF-β-dependent fibrotic replacement. This novel strategy offers a new opportunity for the catheter-based theranostic strategy.

Construction and application of bifunctional AIE fluorescent probe for the detection of Cys and viscosity

A bifunctional fluorescent probe, A-1, was designed and synthesized for the recognition of Cys and viscosity. In the high-viscosity system, the intramolecular rotation of A-1 is restricted, which activates its near-infrared fluorescence. Simultaneously, the probe specifically detects Cys using acrylate as the recognition site. It possesses advantages such as high sensitivity, low detection limit, large Stokes shift (140 nm), high selectivity, and anti-interference properties. In addition, the probe A-1 can target mitochondria before recognition, and aggregate in lipid droplets after reacting with Cys. Based on the above excellent properties, it has been used to monitor changes in Cys and viscosity levels in living cells. And for the first time, it has revealed fluctuations in Cys and viscosity levels in the apoptosis model induced by Cisplatin. This provides a powerful tool for an in-depth study of related disease mechanisms.

Lysosome-Targeted Polarity-Sensitive NIR Fluorescence Probe for Imaging Injured Lung and Liver in Diabetes.

Diabetes is a chronic disease marked by high blood glucose. With the progress of diabetes, complications gradually appear, and various organs may be affected. However, due to the lack of noninvasive in situ detection probes, the diagnosis of organ damage caused by diabetes is significantly delayed, which will cause many complications that cannot be treated in time. Here, we report a BODIPY-based fluorescent probe SNL, which can be used to detect lung and liver damage caused by diabetes. By introducing methylpiperazine and extending the conjugated system, SNL can locate lysosomes and exhibit absorption and emission both in the near-infrared (NIR) region. In addition, SNL is sensitive to polarity and can be used for sensitive detection of lysosomal polarity changes. Unexpectedly, SNL targets and images the lungs and liver of mice. Subsequently, hyperglycemia-stimulated cell models and diabetic mouse models were successfully established, and SNL was utilized to reveal that polarity can be used as a diagnostic signal of diabetic complications. Notably, SNL for the first time confirmed the lung injury and liver injury caused by diabetes using the fluorescent probes method, providing a new approach for the diagnosis of diabetes complications.

Indocyanine green near-infrared fluorescence bowel perfusion assessment to prevent anastomotic leakage in minimally invasive colorectal surgery (AVOID): a multicentre, randomised, controlled, phase 3 trial

Anastomotic leakage is a severe postoperative complication in colorectal surgery and compromised bowel perfusion is considered a major contributing factor. Conventional methods to assess bowel perfusion have a low predictive value for anastomotic leakage. We therefore aimed to evaluate the efficacy of real-time assessment with near-infrared (NIR) fluorescence imaging with indocyanine green (ICG) in the prevention of anastomotic leakage. This multicentre, randomised, controlled, phase 3 trial was done in eight hospitals in the Netherlands. We included adults (aged >18 years) who were scheduled for laparoscopic or robotic colorectal surgery (with planned primary anastomosis) for benign and malignant diseases. Preoperatively, patients were randomly assigned (1:1) to fluorescence-guided bowel anastomosis (FGBA) or conventional bowel anastomosis (CBA) by variable block randomisation (block sizes 4, 6, and 8) and stratified by site. The operating surgeon and investigators analysing the data were not masked to group assignment. Patients were unmasked after the surgical procedure or after study end. In the FGBA group, surgeons marked anastomosis levels per conventional perfusion assessment and then administered 5 mg of ICG by 2 mL intravenous bolus. They assessed bowel perfusion using NIR fluorescence imaging and adjusted (or kept) transection lines accordingly. Only conventional methods for bowel perfusion assessment were used in the CBA group. The primary outcome was the difference in the rate of clinically relevant anastomotic leakage (ie, requiring active therapeutic intervention but manageable without reoperation [grade B] or requiring reoperation [grade C], per the International Study Group of Rectal Cancer) between the FGBA group and the CBA group within 90 days post-surgery. The primary outcome and safety were assessed in the intention-to-treat population. This study was registered with ToetsingOnline.nl (NL7502) and ClinicalTrials.gov (NCT04712032) and is complete. Between July 2, 2020, and Feb 21, 2023, 982 patients were enrolled, of whom 490 were assigned to FGBA and 492 were assigned to CBA. After excluding 51 patients, the intention-to-treat population comprised 931 (463 assigned FGBA and 468 assigned CBA). Patients had a median age of 68·0 years (IQR 59·0-75·0) and 485 (52%) were male and 446 (48%) were female. Ethnicity data were not available. The overall 90-day rate of clinically relevant anastomotic leakage was not significantly different between the FGBA group (32 [7%] of 463 patients) and the CBA group (42 [9%] of 468 patients; relative risk 0·77 [95% CI 0·50-1·20]; p=0·24). No adverse events related to ICG use were observed. 313 serious adverse events in 229 (25%) patients were at 90-day follow-up (159 serious adverse events in 113 [24%] patients in the FGBA group and 154 serious adverse events in 116 [25%] patients in the CBA group). 18 (2%) people died by 90 days (ten in the FGBA group and eight in the CBA group). ICG NIR fluorescence imaging did not reduce 90-day anastomotic leakage rates in this trial across all types of colorectal surgeries. Further research should be done in subgroups, such as rectosigmoid resections, for which evidence suggests ICG NIR might be beneficial. Olympus Medical, Diagnostic Green, and Intuitive Foundation.

Investigations of fluorescence emission Mechanism: Formation of ring-like structures by interactions influenced by hydroxyl group and deprotonation

As one of the gaseous signaling molecules in biological systems, hydrogen sulfide(H2S) is involved in numerous physiological processes and diseases. Therefore, rapid, effective, and real-time detection of H2S is of great importance. Based on its excellent optical properties, dicyanoisophorone has attracted much attention in recent years, and a large number of corresponding probes have been developed to detect H2S in biological systems. In this paper, the fluorescence mechanisms of three dicyanoisophorone-based fluorescent probes are investigated and the near-infrared (NIR) fluorescence attribution of the products is discussed by density-functional theory and time-dependent density-functional theory methods. Frontier molecular orbital analysis shows that the non-fluorescence of the probes is attributed to the photo-induced electron transfer process. Structural change and reduced density gradient analyses indicate that the position of the hydroxyl group and the deprotonation have a non-negligible influence on the interactions within the products. The five- or six-membered ring-like structures formed by interactions make the molecule stain as a planar and the fluorescence emission, while the twist exists the fluorescence quenching. In addition, spectral information shows that the emission of NIR fluorescence originates from the deprotonated form of the product.

Detection of Hepatocellular Carcinoma in an Orthotopic Patient-Derived Xenograft with an Epithelial Cell Adhesion Molecule-Specific Peptide.

Hepatocellular carcinoma (HCC) has emerged as a major contributor to the worldwide cancer burden. Improved methods are needed for early cancer detection and image-guided surgery. Peptides have small dimensions that can overcome delivery challenges to achieve high tumor concentrations and deep penetration. We used phage display methods to biopan against the extra-cellular domain of the purified EpCAM protein, and used IRDye800 as a near-infrared (NIR) fluorophore. The 12-mer sequence HPDMFTRTHSHN was identified, and specific binding to EpCAM was validated with HCC cells in vitro. A binding affinity of kd = 67 nM and onset of k = 0.136 min-1 (7.35 min) were determined. Serum stability was measured with a half-life of T1/2 = 2.6 h. NIR fluorescence images showed peak uptake in vivo by human HCC patient-derived xenograft (PDX) tumors at 1.5 h post-injection. Also, the peptide was able to bind to foci of local and distant metastases in liver and lung. Peptide biodistribution showed high uptake in tumor versus other organs. No signs of acute toxicity were detected during animal necropsy. Immunofluorescence staining of human liver showed specific binding to HCC compared with cirrhosis, adenoma, and normal specimens.