Endoscopic resection of extra-luminal gastric gastrointestinal stromal tumors using a snare assisted external traction technique (with video).

OBJECTIVE: The primary purpose of the study was to explore the clinical efficacy of the novel snare assisted endoscopic resection of extraluminal growing gastric gastrointestinal stromal tumors (gastric GISTs) using external traction, and the secondary purpose was to compare the novel snare assisted endoscopic resection of extraluminal GISTs with the standard laparoscopic procedure. METHODS: We retrospectively analyzed the patients who underwent novel external traction assisted endoscopic resection or laparoscopic resection for their extraluminal gastric GIST ≤5 cm in diameter. RESULTS: A total of 111 patients (27 in the endoscopic group and 84 in the laparoscopic group) were included in this study. There was no significant difference in tumor diameter and complication rate between the two groups. The overall procedure time was slightly higher in the endoscopic group compared to the laparoscopic group (P = 0.034). However, postoperative hospitalization time (P < 0.001) and postoperative fasting time (P = 0.005) were shorter in the endoscopic group compared to the laparoscopic group. CONCLUSION: Snare external traction-assisted endoscopic resection of extraluminal growing gastric GISTs is safe and effective, and it provides a new adjunctive method for endoscopic resection of GIST.

Effect of Abdominal Compression on Total Single-Balloon Enteroscopy Rate: A Randomized Controlled Trial.

OBJECTIVE: To evaluate whether abdominal compression significantly increased the total enteroscopy rate in single-balloon enteroscopy (SBE). METHODS: Consecutive patients who underwent SBE at 2 hospitals were prospectively included between June 1, 2020, and September 30, 2021. They were randomly divided into an abdominal compression group and a non-abdominal compression group with use of sealed envelopes generated by a computer. Total enteroscopy rates were compared between the groups. RESULTS: The study included 200 patients. The total enteroscopy rates were 73% and 16% in the abdominal compression and non-abdominal compression groups, respectively (relative risk, 13.55; 95% CI, 6.79 to 27.00; P<.001). The total enteroscopy rate was higher in the 70 patients who were identified to have undergone no previous abdominal surgery or small intestinal stenosis than in the 32 patients who had undergone such procedures in the abdominal compression group (84% vs 47%; relative risk, 6.08; 95% CI, 2.36 to 15.67; P<.001). Relevant positive findings were not significantly different between the groups (58% vs 45%; P=.07). Binary logistic regression analysis found abdominal compression to be associated with a better total enteroscopy rate (odds ratio, 16.68; 95% CI, 7.92 to 35.15; P<.001), and the presence of previous abdominal surgery or small intestinal stenosis was associated with difficulty in completing the total enteroscopy procedure (odds ratio, 0.26; 95% CI, 0.12 to 0.58; P<.01). CONCLUSION: Abdominal compression significantly increased the total enteroscopy rate in SBE. Complete total enteroscopy may be challenging in patients with a history of abdominal surgery or small intestinal stenosis.

[Differences in the ecological resilience of planted and natural Pinus massoniana and Cunninghamia lanceolata forests in response to drought in subtropical China]. / 亚热带人工和天然马尾松、杉木林生长对干旱的生态弹性差异.

We sampled Pinus massoniana and Cunninghamia lanceolata in both plantation and natural forests in central and western Fujian Province, China. Using tree-ring width, tree-ring width index, and basal area increment, we reconstructed the annual growth of 109 conifer individuals from four sites for the 20-year period from 1993 to 2012. We then calculated resistance, recovery, and resilience indices of those trees in response to two consecutive extreme droughts (2003-2004 and 2011) and analyzed the differences in resistance and resilience between plantations and natural fore-sts. The results showed that there were temporal differences in moisture requirements between P. massoniana and C. lanceolata, which accounted for their inconsistent responses to drought in 2003-2004. For both species, drought induced a marked growth reduction, without any clear lag effect. The growth responses during and following the 2003-2004 drought were significantly stronger than that for the 2011 drought. Those results indicated that P. massoniana was more resilient to drought stress than C. lanceolata, and the natural forests were more sensitive than plantations, but with stronger capacity to recover. C. lanceolata plantations were more susceptible to frequent extreme drought events. To mitigate the vulnerability of plantation trees to more frequent droughts in the future, we suggested select trees from genetic provenances with strong drought resistance.

[Ecological resilience of ancient Pinus massoniana trees to climate change and insect infestation in southeastern Fujian, China]. / é—½ä¸œå—åœ°åŒºé©¬å°¾æ¾å¤æ ‘å¯¹æ°”å€™å˜åŒ–å’Œè™«ç¾çš„ç”Ÿæ€å¼¹æ€§.

Pinus massoniana is a typical pioneer afforestation tree species widely distributed in southern China. It is crucial to study the ecological resilience of P. massoniana to disturbances under global warming, drying, and frequent pest infestation, which can shed lights on forest mana-gements. In this study, tree-ring samples collected from old-growth P. massoniana trees in Baisong Village, Xianyou County, Fujian Province, were used to develop the first standard chronology of P. massoniana ring width (1865-2014) in this region. The results showed that the low relative humidity from July to September and the extremely high temperature from May to September were the main limiting factors for tree growth. The extremely narrow years were identified in 1869, 1889, 1986, 1991 and 1993. These extremely narrow years were exacerbated after the persistently low values of the previously two years via the superposed epoch analysis (SEA). The insect infestations were more likely to happen in dry years. Insect outbreak exerted strongest effect on tree growth in 1889. The narrow tree-rings in 1986 and 1991 were affected by both insect infestation and drought. The other extremely narrow years were mainly affected by drought. The resistance of trees to insect infestation was weaker than that to drought event. The relative resilience of trees to insect infestation was higher than that to drought event, except for 1991. The relative resilience was the highest in 1889 and the lowest in 1991 under the influence of successive extreme events. Under the enhanced drying trend since 2000, more trees had died possibly due to the combined effects of insect infestation and drought.

Intrinsic Expression of Immune Checkpoint Molecule TIGIT Could Help Tumor Growth in vivo by Suppressing the Function of NK and CD8+ T Cells.

TIGIT, an immune checkpoint molecule widely expressed on NK cells, activated T cells and Tregs, has been involved in delivering inhibitory signals through the interaction with PVR. The blockade of TIGIT/PVR interaction is a promising approach in cancer immunotherapy. Here, we unexpectedly discovered the expression of TIGIT in murine tumor cells. To elucidate the mechanism of such intrinsic expression, TIGIT knockout murine colorectal CT26 and MC38 cell lines were generated by using CRISPR/Cas9 system. Although TIGIT knockout showed no effects on proliferation and colony formation of tumor cells in vitro, the tumor growth in mice was considerably inhibited. TIGIT knockout led to the increase of IFN-γ secretion by NK and CD8+ T cells. Further, in BABL/c nude mice, CD8+ T cells depleting mice and NK cells depleting nude mice, the promotion of tumor growth was significantly diminished, suggesting that both NK cells and CD8+ T cells were involved in the tumor promoting process mediated by intrinsic TIGIT. In addition, blocking TIGIT/PVR interaction by the antibody or recombinant PVR protein could elicit anti-tumor effects by facilitating the tumor infiltration and restoring the function of CD8+ T cells, and the antibody-mediate TIGIT blockade could inhibit MC38 tumor growth through blocking TIGIT expressed on tumor cells. We therefore propose a novel TIGIT/PVR interaction mode that tumor intrinsic TIGIT delivers inhibitory signals to CD8+ T cells and NK cells by engaging with PVR.

BC200 LncRNA a potential predictive marker of poor prognosis in esophageal squamous cell carcinoma patients.

OBJECTIVE: To explore the expression and prognosis significance of BC200 in esophageal squamous cell carcinoma (ESCC) patients who received radical resection. METHODS: We used quantitative real-time polymerase chain reaction to detect the expression level of BC200 in cancer tissue and paired adjacent normal tissue samples from 70 ESCC patients who received radical surgical resection and analyzed the correlation of the relative expression level of BC200 with clinical-pathological features and prognosis. RESULTS: We found that the relative expression of BC200 was significantly higher in ESCC tissues compared with adjacent normal tissue samples (P=0.023). But the expression of BC200 were not related to clinical-pathological features, such as age, TNM stages, and histological grade (P>0.05). Kaplan-Meier analysis showed that high expression levels of BC200 were correlated with poor prognosis in ESCC patients. Patients with a high level of BC200 had a shorter disease-free survival and overall survival than those with low BC200 expression (P=0.034 and P=0.031, respectively). On multivariate analysis, the hazard ratio (HR) of BC200 expression was 2.17 (95% confidence interval [CI]=1.12-4.19, P=0.022) for disease-free survival and 2.24 (95% CI=1.12-4.49, P=0.023) for overall survival. CONCLUSION: Our results indicate that high expression of BC200 reflects poor prognosis and could serve as a novel predictive marker for ESCC patients who received radical resection.

The clinical significances of the abnormal expressions of Piwil1 and Piwil2 in colonic adenoma and adenocarcinoma.

OBJECTIVE: The objective of the present investigation was to study the clinical significances of the abnormal expressions of Piwil1 and Piwil2 protein in colonic adenoma and adenocarcinoma. METHODS: This study had applied immunohistochemical method to detect 45 cases of tissues adjacent to carcinoma (distance to cancerous tissue was above 5 cm), 41 cases of colonic adenoma and 92 cases of colon cancer tissues, and their Piwil1 and Piwil2 protein expression levels. ANALYSIS: The correlation of both expression and its relationship with clinicopathological features of colon cancer was analyzed. RESULTS: Positive expression rates of Piwil1 in tissues adjacent to carcinoma, colonic adenoma, and colon cancer were 11.1% (5/45), 53.7% (22/41), and 80.4% (74/92), respectively; the expression rates increased, and the comparisons between each two groups were statistically significant (P<0.05). In each group, the positive expression rates of Piwil2 were 24.4% (11/45 cases), 75.6% (31/41 cases), and 92.4% (85/92 cases); expression rates increased, and the comparisons between each two groups were statistically significant (P<0.05). Piwil1 expression and the correlation of the degree of differentiation, TNM stage, and lymph node metastasis were statistically significant (P<0.05). Piwil2 expression and the correlation of the degree of differentiation, tumor node metastasis (TNM) stage, and lymph node metastasis had no statistical significance (P>0.05). In colon cancer tissue, Piwil1 and Piwil2 expressions were positively correlated (r=0.262, P<0.05). CONCLUSION: The results showed that the abnormal expression of Piwil1 and Piwil2 might play an important role in the process of colon cancer development.

MicroRNA-146a rs2910164 G/C polymorphism and gastrointestinal cancer susceptibility: a meta-analysis based on East Asian population.

OBJECTIVE: The relationship between microRNA (miR-146a) rs2910164G/C polymorphism and gastrointestinal cancer susceptibility is not consistent with each other of the published articles. The aim of this meta-analysis was to acquire a more precise effect of the association between the miR-146a rs2910164 G/C polymorphism and gastrointestinal cancer. MATERIALS AND METHODS: Through searching of the MedLine, Embase, China National Knowledge Infrastructure, and Wanfang databases. Case-control or cohort studies about the relationship between miR-146a rs2910164 G/C polymorphism and gastrointestinal cancer susceptibility were screened and included in this meta-analysis. Quantitative data synthesis was conducted for the associations of miR-146a rs2910164 G/C polymorphism and gastrointestinal cancer risk by statistical software STATA-11.0. RESULTS: Ten studies including 6473 gastrointestinal cancer patients and 7923 controls were identified and included in this meta-analysis. For recessive genetic model (CC vs. CG + GG), people with CG or GG is associated with the susceptibility of gastrointestinal cancer compared with genotype of CC (R = 0.73, 5% confidence interval [CI]: 0.55-0.97, [P = 0.03]); But for dominant model (CC + CG vs. GG) and homozygous model (CC vs. GG), no association of the miR-146a rs2910164G/C polymorphism and gastrointestinal cancer susceptibility were found (dominant: Odds ratio [OR] =0.94, 95% CI: 0.82-1.03, [P = 0.37]; homozygous: OR = 0.85, 95% CI: 0.71-1.03, [P = 0.10]). Sub-group analysis, for homozygous model, people with GG genotype had increased risk of developing colorectal cancer (OR = 0.77, 95% CI: 0.64-0.93, [P = 0.008]). CONCLUSION: No significant association between miR-146a rs2910164G/C polymorphism and gastrointestinal cancer susceptibility was found in this meta-analysis. But for homozygous model, people with GG genotype may have increased risk of developing colorectal cancer.