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Idiopathic mesenteric phlebosclerotic colitis(IMP) is a rare disease. At present, the etiology and pathogenesis are not clear, but the main patients are Asian people, and most of them have a history of taking Chinese herbal medicines. The disease has characteristic endoscopic and imaging manifestations. This paper shares a case of IMP, The patient came to our hospital for one year because of intermittent abdominal pain and diarrhea. It conforms to the typical manifestations of IMP. For patients who take Chinese herbal medicine for a long time, if they have clinical manifestations of gastrointestinal tract, it is necessary to consider the possibility of the disease to avoid serious consequences due to missed diagnosis.
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Colitis , Medicamentos Herbarios Chinos , Humanos , Medicamentos Herbarios Chinos/efectos adversos , Tomografía Computarizada por Rayos X , Venas Mesentéricas/diagnóstico por imagen , Colitis/inducido químicamente , Colitis/diagnóstico por imagen , Colitis/tratamiento farmacológicoRESUMEN
PD-L1+ exosome have been reported to be a promising prognostic biomarker in various cancers. However, its clinical value in diffuse large B cell lymphoma (DLBCL) has not been defined yet. In this study, a total of 165 plasma samples from 78 patients with DLBCL undergoing standard first-line R-CHOP regimens were collected at three different time points (pretreatment, and after 3 and 6 cycles of R-CHOP) to determine the proportions of PD-L1+ exosomes by flow cytometry. We found that high pretreatment plasma PD-L1+ exosome correlated with indicators of poor clinical outcome that included high Ki-67 expression (P = 0.02), double expressor lymphoma (P = 0.005), immunohistochemical PD-L1+ tumor tissue (P = 0.006), and the baseline maximal standardized uptake values (P = 0.0003). Pretreatment plasma PD-L1+ exosome was an independent factor by multivariate analysis with logistic regression (P = 0.0301). Moreover, the pretreatment PD-L1+ exosome was a strong predictor of final treatment responses of either CR or non-CR by ROC analysis (P < 0.001). PD-L1+ exosome level declined significantly in patients who experienced CR (pretreatment vs. after 3 cycles/after 6 cycles, P < 0.05), but not in the non-CR group. Intriguingly, plasma PD-L1+ exosome after 3 cycles (AUC = 0.857; 95%CI: 0.728-0.939) might represent a more sensitive indicator than radiographic assessment after 3 cycles (AUC = 0.626; 95%CI: 0.477-0.758) for evaluating the therapeutic response of DLBCL patients (P = 0.0136). Our results suggest that plasma PD-L1+ exosomes may represent a new biomarker for the dynamic monitoring of treatment response.
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Antígeno B7-H1 , Exosomas , Linfoma de Células B Grandes Difuso , Humanos , Biomarcadores de Tumor/metabolismo , Relevancia Clínica , Exosomas/metabolismo , Exosomas/patología , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Linfoma de Células B Grandes Difuso/metabolismo , PronósticoRESUMEN
OBJECTIVE: To investigate efficacy and safety of endoscopic ultrasonography (EUS) guiding to cut the scar of esophageal stricture after endoscopic injection sclerotherapy (EIS). METHODS: The data of 10 patients with oesophageal stricture after esophageal varices EIS in our hospital from September 1, 2021 to December 31, 2021 treated by cutting the scar guided by ultrasonic endoscopy were retrospective, and the efficacy was evaluated. RESULTS: The dysphagia was obviously relieved in 9 patients during follow-up, and 1 patient suffered dysphagia again after the treatment. There was no complications of perforation, bleeding and infection among the paitents. CONCLUSION: EUS guiding to cut the scar of esophageal stricture after EIS was safe and reliable.
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Trastornos de Deglución , Estenosis Esofágica , Várices Esofágicas y Gástricas , Cicatriz/complicaciones , Trastornos de Deglución/etiología , Trastornos de Deglución/terapia , Endosonografía/efectos adversos , Estenosis Esofágica/diagnóstico por imagen , Estenosis Esofágica/etiología , Estenosis Esofágica/terapia , Várices Esofágicas y Gástricas/complicaciones , Várices Esofágicas y Gástricas/terapia , Hemorragia Gastrointestinal/etiología , Humanos , Estudios Retrospectivos , Escleroterapia/efectos adversosRESUMEN
BACKGROUND: Cancer causes a serious health burden on patients worldwide. Chronic low-level inflammation plays a key role in tumorigenesis and prognosis. However, the role of the red blood cell distribution width (RDW)-to-albumin (RA) ratio in cancer mortality remains unclear. METHODS: In this retrospective cohort study, we collected clinical information from cancer patients from the Medical Information Mart for Intensive Care III (MIMIC-III) version 1.4 database and then calculated RA by dividing RDW by albumin concentration. The primary outcome was 30 days mortality, while secondary outcomes were 90 days and 1 year mortality. Next, we adopted Cox regression models to calculate hazard ratios (HR) together with 95% confidence intervals (CI) for all-cause mortalities associated with the RA ratio. RESULTS: For 30 days mortality, the HR (95% CI) for the high RA ratio (≥5.51) was 2.17 [95CI% (1.87-2.51); p = <0.0001], compared with the low RA ratio (<5.51). In Model 2, we adjusted sex and age and obtained HR (95% CI) of 2.17 [95CI% (1.87-2.52); p = <0.0001] for the high RA ratio (≥5.51) group, compared to that in the low RA ratio (<5.51). In Model 3, adjusting for age, sex, anion gap, hematocrit, white blood cell count, congestive heart failure, SOFA, liver disease, and renal failure resulted in HR (95% CI) of 1.74 [95CI% (1.48-2.04); p = <0.0001] for the high RA ratio (≥5.51) relative to the low RA ratio (<5.51). We also analyzed common diseases in cancer patients but found no significant association. CONCLUSION: To the best of our knowledge, this is the first study demonstrating that increased RA ratio is independently associated with increased all-cause mortality in cancer patients.
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Índices de Eritrocitos , Mortalidad , Neoplasias , Albúminas , Eritrocitos , Humanos , Pronóstico , Estudios RetrospectivosRESUMEN
BACKGROUND: IgG4-related disease mainly manifests as organomegaly and is accompanied by tissue fibrosis (Mimori, Mod Rheumatol 29(2):213, 2019) which is frequently confused with tumour (Dawei et al., J Gastroenterol Hepatol 29(12):1375-8, 2020). There are few reports with of IgG4-related disease with the first clinical manifestation involving the stomach. CASE PRESENTATION: We present the case of 46-year-old male patient with a "stomach tumour" as the first manifestation of IgG4-related disease. Gastroscopy showed a mass in the stomach, however, the pathology result was chronic inflammation with IgG4 positivity. CT scans of abdomen showed that the stomach wall was thick, the head of the pancreas was swollen, and retroperitoneal fibrosis was severe.The serum IgG4 level was 75 g/L (normal range 0.03-2.01 g/L).After treatment with methylprednisolone for one month, the symptoms were greatly relieved. CONCLUSIONS: To reduce the suffering of patients and relieve their financial burden, we should consider the possibility of IgG4-related disease when the initial manifestation is a stomach mass.
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Enfermedad Relacionada con Inmunoglobulina G4 , Fibrosis Retroperitoneal , Gastropatías , Humanos , Inmunoglobulina G , Enfermedad Relacionada con Inmunoglobulina G4/complicaciones , Enfermedad Relacionada con Inmunoglobulina G4/diagnóstico , Enfermedad Relacionada con Inmunoglobulina G4/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Fibrosis Retroperitoneal/diagnóstico , Fibrosis Retroperitoneal/tratamiento farmacológicoRESUMEN
Acute myeloid leukemia (AML) is a highly aggressive disease that causes high mortality. Long noncoding RNA (lncRNA) have studied in recent years that could be a potential biomarker and therapeutic target. Therefore, it is urgently necessary to explore the novel lncRNAs in AML. Microarray analysis was performed to determine the differentially expressed lncRNAs between mononuclear cells of AML and normal samples. The biological function of lncRNA on cell proliferation and migration was measured in vitro. The predicted downstream target of lncRNA was validated by dual-luciferase reporter assay, RNA immunoprecipitation, RNA pull-down, and rescue experiments. The tumor formation and metastasis study were conducted in vivo. The expression of lncRNA in clinical samples was determined by a quantitative reverse transcription-polymerase chain reaction. LINC00449 was one of the most differentially expressed lncRNA which is mainly located in the cytoplasm. We found that overexpression of LINC00449 could inhibit the cell proliferation and invasion of AML cells in vitro and in vivo. Besides, miR-150 was identified as the downstream target gene that was negatively regulated by LINC00449 and FOXD3 was targeted by miR-150. The results were confirmed by dual-luciferase reporter assay, RNA immunoprecipitation, RNA pull-down, rescue experiments, and in vivo assays. Patients with AML with high expression of LINC0049 may characterize a favorable survival. All the above-mentioned findings indicated that the LINC00449/miR-150/FOXD3 signaling pathway might represent a novel prognostic biomarker or therapeutic target for the treatment of AML.
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Proliferación Celular/genética , Leucemia Monocítica Aguda/genética , Leucemia Monocítica Aguda/patología , ARN Largo no Codificante/genética , Biomarcadores de Tumor/genética , Línea Celular Tumoral , Movimiento Celular/genética , Femenino , Factores de Transcripción Forkhead/genética , Regulación Neoplásica de la Expresión Génica/genética , Humanos , Leucemia Mieloide Aguda/genética , Leucemia Mieloide Aguda/patología , Masculino , Persona de Mediana Edad , Pronóstico , Transducción de Señal/genética , Células THP-1 , Células U937RESUMEN
Erbin has been shown to have significant effects on the development of solid tumors. However, little is known about its function and regulatory mechanism in hematological malignancies. The biological function of Erbin on cell proliferation was measured in vitro and in vivo. The predicted target of Erbin was validated by dual-luciferase reporter assay and rescue experiment. We found that overexpression of Erbin could inhibit the cell proliferation and promote the cell differentiation of acute myeloid leukemia (AML) cells, whereas depletion of Erbin could enhance the cell proliferation and block the cell differentiation in AML cells in vitro and in vivo. Besides, miR-183-5p was identified as the upstream regulator that negatively regulated the Erbin expression. The results were confirmed by dual-luciferase reporter and RNA pull-down assay. Furthermore, we found that miR-183-5p negatively regulated Erbin, resulting in enhanced cell proliferation of AML cells via activation of RAS/RAF/MEK/ERK and PI3K/AKT/FoxO3a pathways. The activation of RAS/RAF/MEK/ERK and PI3K/AKT/FoxO3a pathways was mediated by Erbin interacting with Grb2. These results were also validated by rescue experiments in vitro and in vivo. All above-mentioned findings indicated that the miR-183-5p/Erbin signaling pathway might represent a novel prognostic biomarker or therapeutic target for treatment of AML.
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Proteínas Adaptadoras Transductoras de Señales/metabolismo , Diferenciación Celular/fisiología , Proteína Forkhead Box O3/metabolismo , Leucemia Mieloide/metabolismo , Proteínas Adaptadoras Transductoras de Señales/genética , Diferenciación Celular/genética , Proliferación Celular/genética , Proliferación Celular/fisiología , Citometría de Flujo , Proteína Forkhead Box O3/genética , Células HL-60 , Humanos , Leucemia Mieloide/genética , Leucemia Mieloide Aguda/genética , Leucemia Mieloide Aguda/metabolismo , Fosfatidilinositol 3-Quinasas/genética , Fosfatidilinositol 3-Quinasas/metabolismo , Transducción de Señal/genética , Transducción de Señal/fisiología , Células U937RESUMEN
PURPOSE: Carnosic acid (CA) is an important polyphenol mainly isolated from the famous spice and the medicinal plant Rosmarinus officinalis. CA has been shown to exhibit tremendous pharmacological properties which include, but are not limited to, anticancer, antioxidant and anti-inflammatory activities. The current study was designed to evaluate the anticancer effects of CA against chronic myeloid leukemia (CML) which is one of the rare but deadly malignancies both in men and women. METHODS: CML KBM-7 cell line was used in this study. Cell viability was assessed by MTT assay. Apoptosis was detected by DAPI and annexin V/PI staining, cell cycle analysis by flow cytometry and cell invasion by Boyden chamber assay. The microRNA-780 expression was determined by quantitative RT-PCR. RESULTS: Our results indicated that CA exhibits significant anticancer activity on CML KBM-7 cells with an IC50 of 25 µM. The anticancer activity was due to induction of apoptosis and cell cycle arrest. Moreover, it was observed that CA inhibits the proliferation and invasion of CML KBM-7 cells which could mainly be due to downregulation of microRNA- 780 expression as indicated by the quantitative RT-PCR analysis. CONCLUSION: Taken together, we propose that carnosic acid could prove a potential lead compound in the treatment of CML and deserves further in vitro as well as in vivo study.
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Abietanos/farmacología , Proliferación Celular/efectos de los fármacos , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Leucemia Mielógena Crónica BCR-ABL Positiva/genética , MicroARNs/genética , Invasividad Neoplásica/genética , Antineoplásicos Fitogénicos/farmacología , Apoptosis/efectos de los fármacos , Apoptosis/genética , Puntos de Control del Ciclo Celular/efectos de los fármacos , Puntos de Control del Ciclo Celular/genética , Línea Celular Tumoral , Proliferación Celular/genética , Supervivencia Celular/efectos de los fármacos , Supervivencia Celular/genética , Humanos , Transducción de Señal/efectos de los fármacos , Transducción de Señal/genéticaRESUMEN
INTRODUCTION: This pooled analysis study aimed to reveal the prognostic relevance of microRNAs (miRNAs) in patients with diffuse large B-cell lymphoma (DLBCL). MATERIALS AND METHODS: We examined the impact of miRNAs on clinical outcome. Eligible studies were identified and quality assessed using multiple search strategies. Data were extracted from included studies which correlated survival with expression of miRNAs (serum or tissue). RESULTS: We pooled proper studies, and combined the hazard ratios with 95% confidence intervals to estimate strength of the correlations. There were 18 studies including 1950 patients with DLBCL eligible for pooled analysis. We found significant combined HRs for poor overall survival for high expression of miR-21 and low expression of miR-224 in tumor tissue, but for favorable relapse free survival for high expression of miR-21 in serum. Progression free survival was shortened in patients with low expression of miR-199a/b, miR-146b-5p, miR-224 and high expression of miR-222. CONCLUSION: MiRNAs may act as independent prognostic factors in patients with DLBCL, and useful in risk stratification.
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Regulación Neoplásica de la Expresión Génica , Linfoma de Células B Grandes Difuso/diagnóstico , Linfoma de Células B Grandes Difuso/genética , MicroARNs/genética , Supervivencia sin Enfermedad , Humanos , Linfoma de Células B Grandes Difuso/mortalidad , Linfoma de Células B Grandes Difuso/patología , Pronóstico , Modelos de Riesgos Proporcionales , Transducción de SeñalRESUMEN
BACKGROUND: B7-H3 exhibits altered expression in various cancers. However, the correlation between B7-H3 expression and prognosis of cancer patients remains controversial. Therefore, we elicit a meta-analysis to investigate the potential value of B7-H3 in the prognostic prediction in human cancers. MATERIALS AND METHODS: We searched PubMed (last update by June 15th, 2016) to identify studies assessing the effect of B7-H3 on survival of cancer patients. Hazard ratios (HRs) for overall survival (OS), recurrence free survival (RFS) and progression-free survival (PFS) from individual studies were calculated and pooled by using a random-effect or fix-effect model, and heterogeneity and publication bias analyses were also performed. RESULTS: Data from 24 observational studies consisting of 4141 patients were summarized. An elevated baseline B7-H3 was significantly correlated with poor OS (pooled HR = 2.09; 95% CI =1.60-2.74; P < 0.001). Differences across subgroups of tumor type (P = 0.324), year of publication (P = 0.431), ethnicity (P = 0.940), source of HR (P = 0.145), analysis type (P = 0.178) and sample size (P = 0.909) were not significant. Furthermore, high B7-H3 expression also predicted a significantly poor RFS (pooled HR = 1.39; 95% CI = 1.11-1.75; P = 0.004) but not PFS. CONCLUSIONS: This meta-analysis clarifies that elevated B7-H3 expression is significantly associated with poor survival in cancer patients.
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Antígenos B7/genética , Biomarcadores de Tumor/genética , Neoplasias/diagnóstico , Neoplasias/genética , Expresión Génica , Humanos , Estimación de Kaplan-Meier , Neoplasias/mortalidad , Neoplasias/patología , Pronóstico , Modelos de Riesgos ProporcionalesRESUMEN
The widespread occurrence and severity of tuberculosis make it a major global health concern. Abdominal issues often affect the intestine, peritoneum, and lymph nodes, with retroperitoneal involvement being rare. We herein present a case involving a 51-year-old man who experienced abdominal pain and fever. He had a history of pulmonary tuberculosis 1 year prior, which had been cured 6 months before presentation to our hospital. Abdominal unenhanced computed tomography revealed incomplete bowel obstruction. Abdominal enhanced computed tomography showed significant enlargement of the retroperitoneal lymph nodes, which were compressing the intestinal lumen. Colonoscopy indicated that the terminal ileum and colon were normal. Ultrasound-guided percutaneous lymph node aspiration was performed, and Mycobacterium tuberculosis fluorescence staining was positive. After anti-tuberculosis treatment, the patient's abdominal pain and fever improved. Retroperitoneal lymph node tuberculosis presents atypically, and obtaining histopathology early is therefore crucial for diagnosis and treatment.
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Obstrucción Intestinal , Ganglios Linfáticos , Tomografía Computarizada por Rayos X , Tuberculosis Ganglionar , Humanos , Masculino , Persona de Mediana Edad , Tuberculosis Ganglionar/diagnóstico , Tuberculosis Ganglionar/complicaciones , Tuberculosis Ganglionar/patología , Tuberculosis Ganglionar/tratamiento farmacológico , Obstrucción Intestinal/etiología , Obstrucción Intestinal/patología , Obstrucción Intestinal/diagnóstico , Ganglios Linfáticos/patología , Espacio Retroperitoneal/patología , Espacio Retroperitoneal/diagnóstico por imagen , Antituberculosos/uso terapéutico , Mycobacterium tuberculosis/aislamiento & purificaciónRESUMEN
Ethylene-responsive factor (ERF) family genes are crucial for plant growth and development. This study analyzed the functional role of the PagERF110 gene in leaf development of Populus alba×P. glandulosa. PagERF110 contains the AP2 conserved domain and exhibits transcriptional activation activity at its C-terminus. Overexpression of PagERF110 in transgenic poplar trees resulted in reduced leaf size, leaf area, and vein xylem thickness. Yeast two-hybrid (Y2H) and bimolecular fluorescence complementation (BiFC) experiments confirmed that PagERF110 interacts with PagACD32.1. Transcriptome sequencing revealed that PagERF110 regulates the expression of key genes involved in leaf development. Furthermore, yeast one-hybrid (Y1H) assays, GUS staining, and ChIP experiments collectively confirmed that PagERF110 targets the expression of PagHB16. In summation, our findings demonstrate that PagERF110 functions as a negative regulator in poplar leaf development.
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[This retracts the article DOI: 10.3892/etm.2022.11169.].
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BACKGROUND: Postoperative abdominal infections are an important and heterogeneous health challenge. Many samll abdominal abscesses are resolved with antibiotics, but larger or symptomatic abscesses may require procedural management. CASE SUMMARY: A 65-year-old male patient who suffered operation for the left hepatocellular carcinoma eight months ago, came to our hospital with recurrent abdominal pain, vomit, and fever for one month. Abdominal computed tomography showed that a big low-density dumbbell-shaped mass among the liver and intestine. Colonoscopy showed a submucosal mass with a fistula at colon of liver region. Gastroscopy showed a big rupture on the submucosal mass at the descending duodenum and a fistula at the duodenal bulb. Under colonoscopy, the brown liquid and pus were drained from the mass with "special stent device". Under gastroscopy, we closed the rupture of the mass with a loop and six clips for purse stitching at the descending duodenum, and the same method as colonoscopy was used to drain the brown liquid and pus from the mass. The symptom of abdominal pain, vomit and fever were relieved after the treatment. CONCLUSION: The special stent device could be effectively for draining the abdominal abscess respectively from colon and duodenum.
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BACKGROUND: Transarterial chemoembolization (TACE) is a standard treatment for intermediate-stage hepatocellular carcinoma (HCC). The complications of TACE include biliary tract infection, liver dysfunction, tumor lysis syndrome, biloma, partial intestinal obstruction, cerebral lipiodol embolism, etc. There are few reports about tracheal fistula induced by TACE. CASE SUMMARY: A 42-year-old man came to our hospital with cough and expectoration for 1 month after TACE for HCC. Laboratory test results showed abnormalities of albumin, hemoglobin, prothrombin time, C-reactive protein, D-dimer, and prothrombin. Culture of both phlegm and liver pus revealed growth of Citrobacter flavescens. Computed tomography showed infection in the inferior lobe of the right lung and a low-density lesion with gas in the right liver. Liver ultrasound showed that there was a big hypoechoic liquid lesion without blood flow signal. Drainage for liver abscess by needle puncture under ultrasonic guidance was performed. After 1 month of drainage and anti-infection therapy, the abscess in the liver and the infection in the lung were reduced obviously, and the symptom of expectoration was relieved. CONCLUSION: Clinicians should be alert to the possibility of complications of liver abscess and tracheal fistula after TACE for HCC. Drainage for liver abscess by needle puncture under ultrasonic guidance could relieve the liver abscess and tracheal fistula.
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BACKGROUND: Acquired immune deficiency syndrome (AIDS) associated with eosinophilic gastroenteritis is rare. We report a case of duodenal "stone" inducing acute pancreatitis with eosinophilic gastroduodenitis in an AIDS patient. CASE SUMMARY: A 73-year-old female AIDS patient came to the hospital with recurrent abdominal pain for 20 days. Computed tomography (CT) showed pancreatitis with exudation and a high-density shadow under the gastric antrum. Gastroscopy showed that the descending part of the duodenum was blocked by a "stone". The mucosa of the duodenum was rough, and a red polyp was found on the gastric body. The pathology result was chronic inflammation with eosinophilic granulocytes in the duodenal mucosa and gastric body polyp. CONCLUSION: When AIDS patients suffer acute pancreatitis, the possibility of eosinophilic gastroenteritis needs to be considered to enable the patient to accept timely treatment.
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BACKGROUND: Esophageal stricture is one of the complications after esophageal varices sclerotherapy injection (ESI), and the incidence rate is between 2%-10%. AIM: To explore the efficacy of self-expanding metal stent (SEMS) for the stricture after endoscopic injection with cyanoacrylate (CYA) and sclerotherapy for esophageal varices. METHODS: We retrospectively analyzed the efficacy of SEMS to improve the stricture after endoscopic injection with CYA and sclerotherapy for esophageal varices in 4 patients from February 2023 to June 2023. RESULTS: The strictures were improved in four patients after stenting. The stent was removed after two weeks because of chest pain with embedding into esophageal mucosa in one patient. The stent was removed after one month, however, the stent was reinserted because of the strictures happening again in two patients. The stent was removed after three months, however, the stent was reinserted because of the strictures happening again in one patient. The stent embedded into esophageal mucosa in three patients. There were 3 patients suffered reflux esophagitis, and the acid reflux was relieved by taking hydrotalcite. There was no other complication of esophageal perforation, bleeding from varices or infection. CONCLUSION: SEMS may relieve the stricture which happened after endoscopic injection with CYA and sclerotherapy for esophageal varices. However, when we should remove the stent still needs to be explored.
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BACKGROUND: The stent embedded in the esophageal mucosa is one of the complications after stenting for esophageal stricture. We present a case of stent adjustment with the aid of a transparent cap after endoscopic injection of an esophageal varices stent. CASE SUMMARY: A 61-year-old male patient came to the hospital with discomfort of the chest after the stent implanted for the stenosis because of endoscopic injection of esophageal varices. The gastroscopy was performed, and the stent embedded into the esophageal mucosa. At first, we pulled the recycling line for shrinking the stent, however, the mucosa could not be removed from the stent. Then a forceps was performed to remove the mucosa in the stent, nevertheless, the bleeding form the mucosa was obvious. And then, we used a transparent cap to scrape the mucosa along the stent, and the mucosa were removed successfully without bleeding. CONCLUSION: A transparent cap helps gastroscopy to remove the mucosa embedded in the stent after endoscopic injection of the esophageal varices stent.
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BACKGROUND: Betel nut chewing is very common in Southeast Asia and other tropical countries. Much clinical evidence suggests that chewing betel nut has pro-inflammatory and carcinogenic effects, but there are few clinical reports of acute toxicity caused by it, especially involving esophageal damage. CASE PRESENTATION: We presented a case of a 72-year-old female who was admitted to our hospital for chest pain and hematemesis within several minutes after chewing betel nut. Gastroscopy showed two longitudinal ridge-like mucosal eminences in the esophagus located 20 cm from the incisors down to the gastric cardia, which was similar to varices. At last, a CT scan showed concentric-circle thickening of the esophagus wall, suggesting hematomas. Our treatment included fasting, inhibiting gastric acid and maintaining blood volume. After one week of medical treatment, rechecked gastroscopy showed that esophageal hematomas were gradually absorbed, with the formation of multiple shallow ulcers. CONCLUSIONS: The acute toxicity of chewing betel nut can be easily overlooked. Patients who experience chest pain or hematemesis after chewing betel nut products,especially those who take aspirin at the same time, need to be alert to esophageal hematoma.