Fibrin sealant for closure of mucosal penetration at the oesophagus or cardia during submucosal tunnelling endoscopic resection for gastrointestinal submucosal tumours.

BACKGROUND AND STUDY AIM: To assess the efficacy and safety of a fibrin sealant for the prevention of leak resulting from mucosal penetration at the esophagus or cardia during a STER procedure to remove gastrointestinal submucosal tumors (SMTs). PATIENTS AND METHODS: Between April 2014 and October 2022, a total of 290 patients with oesophageal or cardiac SMTs underwent STER at our centre. We retrospectively identified patients with oesophageal or cardia SMTs who underwent STER and experienced mucosal penetration of the cardia or oesophagus during the procedure. A total of 31 mucosal penetrations in 30 procedures were included. Of the 31 mucosal penetrations, 12 occurred in the cardia, and the other 19 occurred in the oesophagus. All 31 sites received the fibrin sealant to close the mucosal penetration. Clinical characteristics, procedure-related parameters, detailed data of the mucosal penetrations, and treatment outcomes using the fibrin sealant were reviewed for all 30 patients to assess the efficacy and safety of the fibrin sealant for closure of mucosal penetration at the cardia or oesophagus. RESULTS: For the 31 mucosal penetrations, the mean size was 0.08 ± 0.06 cm2 (range 0.01-0.25 cm2). Mucosal closure using the fibrin sealant was performed successfully in all 31 mucosal penetrations. Of the 31 mucosal penetrations, clips were used in 13 cases. All 30 patients were discharged after a median of 7 days (range 4-20 day) postoperatively. During a mean 62 months (range 6-107 months) follow-up, all 31 mucosal penetrations successfully healed without the occurrence of infection, ulcer, oesophagitis, chest infection or abdominal infection. CONCLUSION: For the closure of mucosal penetration during STER at the cardia or oesophagus, a fibrin sealant is both safe and efficacious. It is necessary to conduct more research on the viability, effectiveness, and safety of using a fibrin sealant to close wider mucosal penetrations.

A systematic review and meta-analysis of endocrine-related adverse events associated with interferon.

Objectives: To perform a systematic review and meta-analysis of interferon and endocrine side effects, including their incidence, evaluation, and management. Methods: PubMed was searched through March 7th, 2021, by 2 authors independently (LH Wang and H Zhao). Early phase I/II, phase III experimental trials, prospective and retrospective observational studies were included. Stata 16.0 (StataCorp LLC, 16.0) was the main statistical software for meta-analysis. The weighted incidence and risk ratio were estimated for primary thyroid disease and diabetes mellitus. Results: A total of 108 studies involving 46265 patients were included. Hypothyroidism was the most common thyroid disorder, followed by hyperthyroidism. IFN α+RBV treated patients experienced hypothyroidism in 7.8% (95%CI, 5.9-9.9), which was higher than IFN α (5.2%; 95%CI, 3.7-6.8) and IFN ß (7.0%; 95%CI, 0.06-23.92). IFN α+RBV treated patients experienced hyperthyroidism in 5.0% (95%CI, 3.6-6.5), which was higher than IFN α (3.5%; 95%CI, 2.5-4.8) and IFN ß (3.4%; 95%CI, 0.9-7.5). The summary estimated incidence of painless thyroiditis was 5.8% (95%CI, 2.8-9.8) for IFN α, and 3.5% (95%CI,1.9-5.5) for IFN α+RBV. The summary estimated incidence of diabetes was 1.4% (95%CI, 0.3-3.1) for IFN, 0.55% (95%CI, 0.05-1.57) for IFN α, 3.3% (95%CI,1.1-6.6) for IFN α+RBV. Conclusions: Our meta-analysis shows a high incidence of endocrine adverse events provoked by IFN, further reinforced by combined RBV treatment. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42022334131.

Downregulation of caveolin-1 promotes murine breast cancer cell line progression by highly glycosylated CD147.

Caveolin-1 (CAV-1) can extensively regulate lipid transportation, cell growth and cell death. In the present study, we revealed a novel function of CAV-1 in inhibiting glycosylation of other molecules in murine breast cancer cell line. After the silencing of CAV-1, we found that the mRNA and protein expressions of cluster of differentiation 147 (CD147) and its related molecules (MCT4, matrix metalloproteinase MMP2 and MMP9) increased in the breast cancer cells. Meanwhile, the migration and invasion of the breast cancer cells were significantly enhanced assessed by cell wound healing experiment and transwell assays. Further, the gelatin zymography and lactate assay in the cells also showed the strengthened enzyme activity of MMP9 and the increased extracellular lactate concentration, respectively, after the silencing of CAV-1. Notably, the glycosylation level of CD147 overtly increased after the inhibition of CAV-1 detected by Western Blot analysis, whereas upregulation of CAV-1 did the opposite. Therefore, the findings suggest that the downregulation of CAV-1 can promote breast cancer cell progression probably by highly glycosylated CD147.

The influence of the COVID-19 epidemic on the gastrointestinal endoscopy practice in China: a national survey.

BACKGROUND AND AIM: With the worldwide spread of coronavirus disease 2019 (COVID-19), it has devastated the economy and taken a toll on people' life in every aspects. In this study, we aimed to evaluate the influence of the COVID-19 epidemic on the GI endoscopy practice in China. METHODS: The nationwide survey conducted from 13 to 19 April, 2020. A predesigned standard structured questionnaire was sent to all members of the Chinese Society of Digestive Endoscopy (CSDE) in mainland China by email. Number of various GI endoscopic procedures and participants getting endoscopic training from January 1 to April 10, 2020 (the COVID-19 period) and the same period of 2019 were collected and analyzed. RESULTS: A total of 468 hospitals responded to this survey, and most of them (85.4%) were tertiary referral hospitals. The sum number of GI endoscopic procedures deceased significantly from 3,203,594 in 2019 to 1,512,619 in 2020, including 2,996,779 to 1,401,665 of diagnostic procedures and 206,815 to 110,954 of therapeutic procedures. More than half of centers (57.1%) reduced about 1,000-5,000 endoscopic activities. Of 271 hospitals (57.9%) providing endoscopic training, the total number of participants decreased from 2,977 in 2019 to 1,131 in 2020. Most of hospitals (93.8%) adhered to the recommendation of endoscopy practice issued by CSDE during the outbreak of COVID-19, and there was no cases of infection in endoscopic departments of all surveyed hospitals. CONCLUSION: With the influence of the COVID-19 epidemic, there has been significant decease of GI endoscopy practice in mainland China.

[Tissue culture and polyploidy induction of Morinda officinalis].

OBJECTIVE: To establish an effective protocol for plant generation and induce polyploidy of Morinda offcinalis. METHOD: Callus was induced from immature embryo of M. officinalis and polyploidy was inducted by using colchicine treatment method. Chromosome was detected by flow cytometry. RESULT AND CONCLUSION: The highest induction rate of polyploidy was 18.40%, which was obtained with 500 mg x L(-1) colchicine treatment for 5 days. Roots of polyploid were bigger than diploid. Advantages of using immature embryo as explants are easy for sterilization, higher rate of callus induction and low degree dedifferentiation. The induced polyploidy of M. officinalis may have a value for spread of cultivation.

A phase II clinical trial with cytotropic heterogeneous molecular lipids (CHML) for patients with hepatic malignancies.

Hepatocellular carcinoma (HCC) and other forms of metastatic liver cancer (MLC) have poor outcomes due to the limited treatment options. Surgery, radiotherapy and chemotherapy have a limited success. Thus, there is an urgent need for novel therapies for patients with advanced HCC and MLC. The response and toxicity profile of a novel biological anticancer agent, cytotropic heterogeneous molecular lipids (CHML), in 135 Asian patients with hepatic malignancies treated at five different hospitals in China from April 1998 to August 2003 is described. This trial included 97 patients with HCC and 38 with MLC. The majority of these patients had received conventional therapies and many had failed to respond or relapsed. CHML was administered by intra-arterial (i.a.) infusion with or without simultaneous intravenous (i.v.) infusion for 25 days with a rest of 2-4 weeks between each cycle. Fifty three percent of patients received two cycles, and 47% received three cycles. The complete response (CR) rates were 23% for HCC and 29% for MLC with an overall CR of 24%. The overall partial response (PR) was 53%. The patients with earlier stages and limited tumor burden had a better response, but a few patients with advanced disease also achieved PR. The patients who achieved CR or PR had a significant increase in long-term survival for up to five years. The treatment with CHML resulted in minimal toxicity and the reported adverse reactions were not higher than grade II. CHML is an effective therapy for hepatic malignancies, showing responses and increases in survival in patients in whom other therapies have failed. CHML is well tolerated and is an excellent candidate for Phase III clinical trials.