Diagnostic value of new biliary biopsy cannulae for malignant bile duct strictures via endoscopic retrograde cholangiopancreatography pathway.

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) plays a major role in the diagnosis of malignant biliary strictures. ERCP fluoroscopy-guided biliary biopsy is more sensitive than brushing, but it is more difficult to perform and less successful. Therefore, a new technique of biliary biopsy using a new biliary biopsy cannula via the ERCP route was developed in our center with the aim of improving the diagnosis rate of malignant biliary strictures. METHODS: This is a retrospective study that included 42 patients who underwent ERCP-guided biliary brushing and biliary biopsy for biliary strictures using a new biliary biopsy cannula in our department from January 2019 to May 2022. The final diagnosis was determined after brushing, biliary biopsy under the new biliary biopsy cannula or adequate follow-up. Diagnostic rates were calculated and analyzed for relevant factors. RESULTS: The satisfactory rates of pathological specimens of 42 patients who underwent bile duct biopsy with bile duct brush and new bile duct biopsy cannula were 57.14% and 95.24% respectively. Cholangiocarcinoma was diagnosed in 45.23% and 83.30% of the samples by biliary brush examination and biliary biopsy using the new biliary biopsy cannula, respectively (p < 0.001). CONCLUSIONS: The ERCP route using a new biliary biopsy cannula for biliary biopsy technique can improve pathology positivity and benefit ratio. It provides a new approach in the diagnosis of malignant stenosis in the bile duct.

Clinical guideline on magnetically controlled capsule gastroscopy (2021 edition).

With the development and generalization of endoscopic technology and screening, clinical application of magnetically controlled capsule gastroscopy (MCCG) has been increasing. In recent years, various types of MCCG are used globally. Therefore, establishing relevant guidelines on MCCG is of great significance. The current guidelines containing 23 statements were established based on clinical evidence and expert opinions, mainly focus on aspects including definition and diagnostic accuracy, application population, technical optimization, inspection process, and quality control of MCCG. The level of evidence and strength of recommendations were evaluated. The guidelines are expected to guide the standardized application and scientific innovation of MCCG for the reference of clinicians.

Aquaporin 1 is a prognostic marker and inhibits tumour progression through downregulation of Snail expression in intrahepatic cholangiocarcinoma.

BACKGROUND: Recently, some studies have suggested a link between AQP1 and cancer progression. AIMS: The aim of the present study was to investigate the influence of AQP1 on the clinicopathology and prognosis of intrahepatic cholangiocarcinoma (ICC) patients. METHODS: We retrospectively detected the expression of AQP1 protein in 307 patients with ICC who underwent partial hepatectomy. Western blot analysis was used to detect AQP1 protein levels in stable AQP1 overexpression and knockdown cell lines. The influence of AQP1 on the invasion and metastasis ability of ICC cells was assessed by wound-healing and Transwell assays in vitro as well as by a splenic liver metastasis model in vivo. RESULTS: Positive membranous AQP1 expression was identified in 34.2% (105/307) of the ICC specimens. Survival data revealed that positive AQP1 expression was significantly associated with favourable disease-free survival (DFS) and overall survival (OS) (p = 0.0290 and p = 0003, respectively). Moreover, high AQP1 expression inhibited the invasion and migration of ICC cells in vitro as well as inhibited liver metastasis in nude mice. Mechanistically, high AQP1 expression in ICC cells increased the levels of E-cadherin but decreased the levels of the Snail transcription factor. CONCLUSIONS: AQP1 expression is associated with a favourable prognosis in ICC patients. AQP1 inhibits ICC cell invasion, metastasis, and epithelial-mesenchymal transition (EMT) through downregulation of Snail expression.

[Relationship between electroacupuncture-induced regulatory effect on leukocytes and the caliber of splenic sinusoid basal lamina eyehole on rabbits].

OBJECTIVE: To study the underlining mechanism of electroacupuncture (EA) in regulating leukocyte counts in the rabbit. METHODS: A total of 75 rabbits were randomly divided into normal control, leukocytosis model, leukocytosis + EA, leukopenia model, leukopenia+EA groups, with 15 cases in each. EA (2-20 Hz, 1-2 mA) was applied to "Dazhui" (DU 14), bilateral "Zusanli" (ST 36) and bilateral "Geshu" (BL 17) for 20 min, once daily for 5 days. Leukocytosis and leukopenia models were duplicated by intravenous injection of coliform (0.1 ml/kg) and cyclophosphamide (30 mg/kg) separately. Peripheral blood leukocyte counts were detected every day. At the end of the experiment, the rabbit's spleen tissue was collected under anesthesia, and the diameter of splenic sinusoid basal lamina eyehole was measured under scanning electronic microscope. RESULTS: Compared with normal control group, after i.v. coliform and cyclophosphamide, leukocytes increased and decreased significantly and respectively, while the area of the splenic sinusoid basal lamina eyehole in leukocytosis model group increased lightly and that of leukopenia model group reduced obviously (P < 0.01). In comparison with their individual model group, the leukocyte count in leukocytosis + EA group decreased considerably (P < 0.05), while that of leukopenia + EA group increased markedly (P < 0.01). The area of splenic sinusoid basal lamina eyehole in leukocytosis+ EA group decreased apparently (P < 0.05), and that in leukopenia+ EA group increased remarkably (P < 0.05). CONCLUSION EA is able to regulate the leukocyte counts in coliform-induced leukocytosis and cyclophosphamide-induced leukopenia rabbits, which may be related with its effects in improving the splenic sinusoid basal lamina eyehole activity.