Background:High-protein diets can increase the colonic health risks.A moderate reduction of dietary crude-protein(CP)level can improve the colonic bacterial community and mucosal immunity of pigs.However,greatly reduc...Background:High-protein diets can increase the colonic health risks.A moderate reduction of dietary crude-protein(CP)level can improve the colonic bacterial community and mucosal immunity of pigs.However,greatly reducing the dietary CP level,even supplemented with all amino acids(AAs),detrimentally affects the colonic health,which may be due to the lack of protein-derived peptides.Therefore,this study evaluated the effects of supplementation of casein hydrolysate(peptide source)in low-protein(LP)diets,in comparison with AAs supplementation,on the colonic microbiota,microbial metabolites and mucosal immunity in pigs,aiming to determine whether a supplementation of casein hydrolysate can improve colonic health under very LP level.Twenty-one pigs(initial BW 19.90±1.00 kg,63±1 days of age)were assigned to three groups and fed with control diet(16%CP),LP diets(13%CP)supplemented with free AAs(LPA)or casein hydrolysate(LPC)for 4 weeks.Results:Compared with control diet,LPA and LPC diet decreased the relative abundance of Streptococcus and Escherichia coli,and LPC diet further decreased the relative abundance of Proteobacteria.LPC diet also increased the relative abundance of Lactobacillus reuteri.Both LP diets decreased concentrations of ammonia and cadaverine,and LPC diet also reduced concentrations of putrescine,phenol and indole.Moreover,LPC diet increased total short-chain fatty acid concentration.In comparison with control diet,both LP diets decreased protein expressions of Toll-like receptor-4,nuclear factor-κB,interleukin-1βand tumor necrosis factor-α,and LPC diet further decreased protein expressions of nucleotide-binding oligomerization domain protein-1 and interferon-γ.LPC diet also increased protein expressions of G-protein coupled receptor-43,interleukin-4,transforming growth factor-β,immunoglobulin A and mucin-4,which are indicators for mucosal defense activity.Conclusions:The results showed that supplementing casein hydrolysate showed beneficial effects on the colonic microbiota and mucosal immunity and barrier function in comparison with supplementing free AAs in LP diets.These findings may provide new framework for future nutritional interventions for colon health in pigs.展开更多
Background Cold regions have long autumn and winter seasons and low ambient temperatures.When pigs are unable to adjust to the cold,oxidative damage and inflammation may develop.However,the differences between cold an...Background Cold regions have long autumn and winter seasons and low ambient temperatures.When pigs are unable to adjust to the cold,oxidative damage and inflammation may develop.However,the differences between cold and non-cold adaptation regarding glucose and lipid metabolism,gut microbiota and colonic mucosal immunological features in pigs are unknown.This study revealed the glucose and lipid metabolic responses and the dual role of gut microbiota in pigs during cold and non-cold adaptation.Moreover,the regulatory effects of dietary glucose supplements on glucose and lipid metabolism and the colonic mucosal barrier were evaluated in cold-exposed pigs.Results Cold and non-cold-adapted models were established by Min and Yorkshire pigs.Our results exhibited that cold exposure induced glucose overconsumption in non-cold-adapted pig models(Yorkshire pigs),decreasing plasma glucose concentrations.In this case,cold exposure enhanced the ATGL and CPT-1αexpression to promote liver lipolysis and fatty acid oxidation.Meanwhile,the two probiotics(Collinsella and Bifidobacterium)depletion and the enrichment of two pathogens(Sutterella and Escherichia-Shigella)in colonic microbiota are not conducive to colonic mucosal immunity.However,glucagon-mediated hepatic glycogenolysis in cold-adapted pig models(Min pigs)maintained the stability of glucose homeostasis during cold exposure.It contributed to the gut microbiota(including the enrichment of the Rikenellaceae RC9 gut group,[Eubacterium]coprostanoligenes group and WCHB1-41)that favored cold-adapted metabolism.Conclusions The results of both models indicate that the gut microbiota during cold adaptation contributes to the protection of the colonic mucosa.During non-cold adaptation,cold-induced glucose overconsumption promotes thermogenesis through lipolysis,but interferes with the gut microbiome and colonic mucosal immunity.Furthermore,glucagon-mediated hepatic glycogenolysis contributes to glucose homeostasis during cold exposure.展开更多
Background:Lactic acid bacteria(LAB)participating in milk fermentation naturally release and enrich the fermented dairy product with a broad range of bioactive metabolites,which has numerous roles in the intestinal he...Background:Lactic acid bacteria(LAB)participating in milk fermentation naturally release and enrich the fermented dairy product with a broad range of bioactive metabolites,which has numerous roles in the intestinal health-promot-ing of the consumer.However,information is lacking regarding the application prospect of LAB fermented milk in the animal industry.This study investigated the effects of lactic acid bacteria-fermented formula milk(LFM)on the growth performance,intestinal immunity,microbiota composition,and transcriptomic responses in weaned piglets.A total of 24 male weaned piglets were randomly divided into the control(CON)and LFM groups.Each group consisted of 6 replicates(cages)with 2 piglets per cage.Each piglet in the LFM group were supplemented with 80 mL LFM three times a day,while the CON group was treated with the same amount of drinking water.Results:LFM significantly increased the average daily gain of piglets over the entire 14 d(P<0.01)and the average daily feed intake from 7 to 14 d(P<0.05).Compared to the CON group,ileal goblet cell count,villus-crypt ratio,sIgA,and lactate concentrations in the LFM group were significantly increased(P<0.05).Transcriptomic analysis of ileal mucosa identified 487 differentially expressed genes(DEGs)between two groups.Especially,DEGs involved in the intestinal immune network for IgA production pathways,such as polymeric immunoglobulin receptor(PIGR),were significantly up-regulated(P<0.01)by LFM supplementation.Moreover,trefoil factor 2(TFF2)in the LFM group,one of the DEGs involved in the secretory function of goblet cells,was also significantly up-regulated(P<0.01).Sequenc-ing of the 16S rRNA gene of microbiota demonstrated that LFM led to selective enrichment of lactate-producing and short-chain fatty acid(SCFA)-producing bacteria in the ileum,such as an increase in the relative abundance of Entero-coccus(P=0.09)and Acetitomaculum(P<0.05).Conclusions:LFM can improve intestinal health and immune tolerance,thus enhancing the growth performance of weaned piglets.The changes in microbiota and metabolites induced by LFM might mediate the regulation of the secretory function of goblet cells.展开更多
A novel oral protein delivery system with enhanced intestinal penetration and improved antigen stability based on chitosan(CS) nanoparticles and antigen-cyclodextrin(CD) inclusion complex was prepared by a precipitati...A novel oral protein delivery system with enhanced intestinal penetration and improved antigen stability based on chitosan(CS) nanoparticles and antigen-cyclodextrin(CD) inclusion complex was prepared by a precipitation/coacervation method. Ovalbumin(OVA) as a model antigen was firstly encapsulated by cyclodextrin, either β-cyclodextrin( β-CD) or carboxymethyl-hydroxypropyl-β-cyclodextrin(CM-HP-β-CD) and formed OVA-CD inclusion complexes, which were then loaded to chitosan nanoparticles to form OVA loaded β-CD/CS or CM-HP-β-CD/CS nanoparticles with uniform particle size(836.3 and 779.2 nm, respectively) and improved OVA loading efficiency(27.6% and 20.4%, respectively). In vitro drug release studies mimicking oral delivery condition of OVA loaded CD/CS nanoparticles showed low initial releases at p H 1.2 for 2 h less than 3.0% and a delayed release which was below to 30% at p H 6.8 for further 72 h. More importantly, after oral administration of OVA loaded β-CD/CS nanoparticles to Balb/c mice, OVA-specific sIgA levels in jejunum of OVA loaded β-CD/CS nanoparticles were 3.6-fold and 1.9-fold higher than that of OVA solution and OVA loaded chitosan nanoparticles, respectively. In vivo evaluation results showed that OVA loaded CD/CS nanoparticles could enhance its efficacy for inducing intestinal mucosal immune response. In conclusion, our data suggested that CD/CS nanoparticles could serve as a promising antigen-delivery system for oral vaccination.展开更多
The 778th Xiangshan Science Conference,themed“Regional Immunity in the Lung and Respiratory Tract:Challenges and Opportunities”,convened in Beijing on April 8–9,2025.Co-chaired by four leading scientists-ProfessorG...The 778th Xiangshan Science Conference,themed“Regional Immunity in the Lung and Respiratory Tract:Challenges and Opportunities”,convened in Beijing on April 8–9,2025.Co-chaired by four leading scientists-ProfessorGeorge FuGao(Institute of Microbiology,Chinese Academy of Sciences),Professor Chen Dong(Westlake University School of Medicine),Professor Zhigang Tian(University of Science and Technology of China).展开更多
The numerous health benefits of olive oil are widely known,however,it also provides anti-allergic properties that have not yet been fully defined.In this study,the anti-allergic activity of olive oil was evaluated by ...The numerous health benefits of olive oil are widely known,however,it also provides anti-allergic properties that have not yet been fully defined.In this study,the anti-allergic activity of olive oil was evaluated by analyzing the clinical symptoms and immune-related factors in BALB/c mice that had ingested600 mg/(kg·day)olive oil for two weeks prior to the evaluation.An allergy model was subsequently constructed for analysis,the results of which showed that the olive oil reduced the scores of allergic symptoms in the mice,and up-regulated the hypothermia and the decline in the immune organ index.Moreover,fewer allergy-related cytokines and reduced intestinal inflammation was discovered in the olive oil-treated group.In addition,analysis of intestinal mucosal immune-related factors revealed that the olive oil promoted the expression of intestinal tight junction proteins(Claudin-1,Occludin,and ZO-1)and IL-22,and helped maintain the integrity of the intestinal epithelial physical barrier.Increased levels of mucin 2 andβ-defensin were also found in the intestinal mucus of the olive oil-treated mice.These findings suggest that the oral administration of olive oil effectively attenuated the ovalbumin-induced allergic immune response in the mice,and had a positive effect on intestinal epithelial mucosal immunity.展开更多
Selenium doped carbon(Se/C),an easily fabricated material,was found to be bio-active and it can serve as an adjuvant to enhance the immune effect of Tween 80/Brij 30(T80/B30)vesicles and Tween 80/polymer cationic surf...Selenium doped carbon(Se/C),an easily fabricated material,was found to be bio-active and it can serve as an adjuvant to enhance the immune effect of Tween 80/Brij 30(T80/B30)vesicles and Tween 80/polymer cationic surfactant PN320(T80/PN320)mixed micelles.The synergistic effect of the combination of T80/B30 vesicles and T80/PN320 mixed micelles with Se/C on nasal mucosal immunity was studied in this work,which might provide theoretical basis for developing the related new adjuvant for nasal immunization of recombinant protein,peptide and split protein vaccine.Since both selenium and carbon were bio-compatible elements,Se/C might be safe for practical applications,and this was also reflected by the low hemolytic activity of the materials.This work not only reports an efficient protocol for adjuvant development,but also significantly expands the application scope of selenium chemistry.展开更多
[Objectives]The aim of this study was to investigate the effects of APS-sEPS(a polysaccharide compound of Astragalus polysaccharides and sulfated Epimedium polysaccharide)on intestinal mucosal immunity and structural ...[Objectives]The aim of this study was to investigate the effects of APS-sEPS(a polysaccharide compound of Astragalus polysaccharides and sulfated Epimedium polysaccharide)on intestinal mucosal immunity and structural morphology.[Methods]Firstly,the diarrhea model was established using the optimal dose of magnesium sulfate in mice.Then,the diarrhea mice were randomly divided into three groups and given either physiological saline(diarrhea model group)or injected with APS-sEPS or APS.The normal mice were selected as a control group.After administration,the duodenum,jejunum and ileum were processed microtome section,and observed for describing the small intestine morphology,villus height and crypt depth.The tissue homogenates of the duodenum,jejunum and ileum were gathered to detect the changes of sIgA,IL-4 and IL-10.[Results]The results indicated that APS-sEPS could effectively relieve diarrhea in mice.In the APS-sEPS group,the villus heights of duodenum,jejunum and ileum were increased and the depth of crypt was reduced.The contents of IL-4,IL-10 and sIgA in jejunum and ileum in APS-sEPS group were significantly higher than that in the control group(P<0.05).[Conclusions]These results indicated that APS-sEPS promoted the recovery of intestinal morphological structure and enhanced the mucosa immunity of the small intestine.展开更多
Endoscopic submucosal dissection(ESD)has emerged as a pivotal therapeutic modality for early gastrointestinal(GI)cancers,providing a minimally invasive approach with curative potential.This technique enables the en bl...Endoscopic submucosal dissection(ESD)has emerged as a pivotal therapeutic modality for early gastrointestinal(GI)cancers,providing a minimally invasive approach with curative potential.This technique enables the en bloc resection of neoplastic lesions confined to the mucosa and submucosa,thereby preserving organ function and reducing the need for more radical surgical interventions.ESD provides diagnostic clarity and enhances patient survival rates when performed by skilled practitioners in the early stages of GI cancers such as esophageal,gastric,and colorectal carcinomas.This article examines the indications,procedural advancements,technical considerations,and outcomes associated with ESD in early GI cancers.The challenges and complications that can arise are also highlighted.Additionally,we discuss the evolving role of novel techniques and adjunctive therapies to improve safety and efficacy.As the field progresses,ESD remains a cornerstone in managing early GI cancers,offering patients a promising option for organ preservation and long-term survival.展开更多
Severe Acute Respiratory Syndrome （SARS） is a deadly infectious disease caused by SARS Coronavirus （SARS-CoV）. Inactivated SARS-CoV has been explored as a vaccine against SARS-CoV. However, safe and potent adjuvan...Severe Acute Respiratory Syndrome （SARS） is a deadly infectious disease caused by SARS Coronavirus （SARS-CoV）. Inactivated SARS-CoV has been explored as a vaccine against SARS-CoV. However, safe and potent adjuvants, especially with more efficient and economical needle-free vaccination are alw needed more urgently in a pandemic. The development of a safe and effective mucosal adjuvant and vaccine ays for prevention of emergent infectious diseases such as SARS will be an important advancement. PIKA, a stabilized derivative of Poly （I：C）, was previously reported to be safe and potent as adjuvant in mouse models. In the present study, we demonstrated that the intraperitoneal and intranasal co-administration of inactivated SARS-CoV vaccine together with this improved Poly （I：C） derivative induced strong anti-SARS-CoV mucosal and systemic humoral immune responses with neutralizing activity against pseudotyped virus. Although intraperitoneal immunization of inactivated SARS-CoV vaccine alone could induce a certain level of neutralizing activity in serum as well as in mucosal sites, co-administration of inactivated SARS-CoV vaccine with PIKA as adjuvant could induce a much higher neutralizing activity. When intranasal immunization was used, PIKA was obligatorily for inducing neutralizing activity in serum as well as in mucosal sites and was correlated with both mucosal IgA and mucosal IgG response. Overall, PIKA could be a good mucosal adjuvant candidate for inactivated SARS-CoV vaccine for use in possible future pandemic.展开更多
Objective To explore the role of curcumin(Cur)in improving IgA nephropathy(IgAN)and its related mechanisms.Methods Fifty 7-month-old miR-23b knockout(miR-23b^(-/-))mice weighing(25±5)g were used to establish an I...Objective To explore the role of curcumin(Cur)in improving IgA nephropathy(IgAN)and its related mechanisms.Methods Fifty 7-month-old miR-23b knockout(miR-23b^(-/-))mice weighing(25±5)g were used to establish an IgAN disease model,and were randomly divided into IgAN group,IgAN+Cur(150 mg/kg)group and IgAN+Cur(300 mg/kg)group using simple randomisation.展开更多
Microbes play a critical role in shaping immune development,with growing interest in how rhinovirus(RV)interacts with the host immune system,particularly in individuals with asthma and chronic obstructive pul-monary d...Microbes play a critical role in shaping immune development,with growing interest in how rhinovirus(RV)interacts with the host immune system,particularly in individuals with asthma and chronic obstructive pul-monary disease(COPD).Disruptions in microbial balance during RV infections can impair immune homeostasis and worsen disease outcomes.Recent studies emphasize RV-induced regulation of antiviral defenses,cytokine production,and immune tolerance.This review explores the interplay between RV,the immune system,and microbiota,highlighting the importance of these interactions in guiding effective therapies for respiratory in-fections.It advances existing literature by considering microbiota-mediated therapies as a novel approach to managing RV exacerbations in respiratory diseases like asthma and COPD.展开更多
BACKGROUND Underwater endoscopic mucosal resection(UEMR)has been shown to be a good treatment option for the management of nonpedunculated polyps≥10 mm since its introduction.However,there is a paucity of randomized ...BACKGROUND Underwater endoscopic mucosal resection(UEMR)has been shown to be a good treatment option for the management of nonpedunculated polyps≥10 mm since its introduction.However,there is a paucity of randomized controlled trials(RCTs)in Asia.AIM To compare the efficacy and safety of UEMR with those of conventional EMR(CEMR)in treating nonpedunculated colorectal lesions.METHODS We carried out this RCT at a tertiary hospital from October 2022 to July 2024.Patients with nonpedunculated colorectal neoplasms ranging from 10 mm to 30 mm in size were randomly assigned to either the UEMR or CEMR group.The primary outcome was the curative resection(R0)rate.The secondary outcomes included en bloc resection,procedure time,adverse events,and the number of clips used for defect closure.RESULTS A total of 260 patients with 260 lesions(130 in each UEMR and CEMR group)were recruited.The median age was 58(27-85)years,the male/female ratio was 1.74,and the median lesion size was 20(10-30 mm)mm.Compared with CEMR,UEMR was associated with a significantly greater curative resection(R0)rate(98.4%vs 90.3%;P=0.007),greater en bloc resection rate(100%vs 94.6%;P=0.014),shorter procedure time(65 vs 185 seconds;P<0.001),lower rate of bleeding complications(1.5%vs 10%;P=0.003),and fewer clips used(2 vs 3;P<0.001).No perforations were observed in either group.CONCLUSION Compared with CEMR,UEMR has a higher R0 rate,greater en bloc resection rate,shorter procedure time,fewer bleeding complications,and clips used in the management of nonpedunculated colorectal neoplasms.展开更多
Hypoxemia is a common pathological state characterized by low oxygen saturation in the blood.This condition compromises mucosal barrier integrity particularly in the gut and oral cavity.However,the mechanisms underlyi...Hypoxemia is a common pathological state characterized by low oxygen saturation in the blood.This condition compromises mucosal barrier integrity particularly in the gut and oral cavity.However,the mechanisms underlying this association remain unclear.This study used periodontitis as a model to investigate the role of platelet activation in oral mucosal immunopathology under hypoxic conditions.Hypoxia upregulated methyltransferase-like protein 4(METTL4)expression in platelets,resulting in N6-methyladenine modification of mitochondrial DNA(mtDNA).This modification impaired mitochondrial transcriptional factor A-dependent cytosolic mtDNA degradation,leading to cytosolic mtDNA accumulation.Excess cytosolic mt-DNA aberrantly activated the cGAS-STING pathway in platelets.This resulted in excessive platelet activation and neutrophil extracellular trap formation that ultimately exacerbated periodontitis.Targeting platelet METTL4 and its downstream pathways offers a potential strategy for managing oral mucosa immunopathology.Further research is needed to examine its broader implications for mucosal inflammation under hypoxic conditions.展开更多
Objective:To explore the clinical feasibility and safety of modified endoscopic mucosal resection for rectal neuroendocrine tumors(R-NETs).Methods:Seventy cases of R-NETs treated with endoscopic mucosal resection in o...Objective:To explore the clinical feasibility and safety of modified endoscopic mucosal resection for rectal neuroendocrine tumors(R-NETs).Methods:Seventy cases of R-NETs treated with endoscopic mucosal resection in our hospital between April 2022 and March 2024 were selected and divided into the control group and the observation group using the mean score method,each with 35 cases.In the control group,traditional endoscopic mucosal resection(EMR)was performed,and in the observation group,modified EMR(endoscopic mucosal resection with ligation apparatus[EMR-L])was performed.The operation time,hospitalization time,operation cost,and related complication rate of the two groups of patients were compared.Results:The operation time(20.36±1.46 min)and hospital stay(3.37±0.51 d)of patients in the observation group were shorter than those of the control group(31.44±2.65 min and 4.73±0.49 d).The cost of the operation in the observation group(7,695.85±1,521.42 yuan)was lower than that of the control group(8,418.62±1219.30 yuan),and the difference was statistically significant(P<0.05).The total incidence of postoperative related complications in the observation group was observed to be 11.42%,which was significantly lower than that of 31.42%in the control group,and the difference was statistically significant(P<0.05).Conclusion:The application of modified EMR in R-NETs is remarkable,which can not only effectively shorten the operation time and hospital stay,but also further reduce the risk of related complications,and indirectly save a large amount of hospital costs;thus,it is recommended to be promoted and applied clinically.展开更多
BACKGROUND Patients diagnosed with esophageal mucosal bridges often experience symptoms such as chest pain and dysphagia,which pose considerable challenges for endo-scopic surgical interventions.CASE SUMMARY We presen...BACKGROUND Patients diagnosed with esophageal mucosal bridges often experience symptoms such as chest pain and dysphagia,which pose considerable challenges for endo-scopic surgical interventions.CASE SUMMARY We present a case involving early-stage esophageal cancer discovered in a resting room,notable for the rare manifestation of esophageal mucosal bridging.Following a comprehensive multidisciplinary discussion and the development of a treatment strategy,we proceeded with endoscopic submucosal dissection for the patient.During the procedure,we encountered operational challenges due to the presence of a diverticulum and a partial absence of the muscularis propria.To facilitate the retraction of a portion of the resected specimen,we utilized dental floss.Ultimately,we successfully excised the entire lesion.After a three-day period of fasting with a water-only diet,subsequent iodine water cholan-giography did not indicate any perforations,and the patient was advised to transition to a liquid diet.The patient was discharged five days post-operation.A follow-up endoscopy conducted three months later revealed scar-like changes in the mid-esophagus,with the patient reporting no significant discomfort.CONCLUSION In summary,although esophageal mucosal bridges are rarely documented,they should be considered in the differential diagnosis of mechanical dysphagia.Furthermore,endoscopic therapy represents a feasible approach for their mana-gement.展开更多
Objective:To analyze the application value of modified endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)in rectal neuroendocrine tumors,with a view to providing new clinical options for the ea...Objective:To analyze the application value of modified endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)in rectal neuroendocrine tumors,with a view to providing new clinical options for the early diagnosis and treatment of patients with such tumors,and thus improving their prognosis.Methods:Seventy-two patients with rectal neuroendocrine tumors who underwent surgical treatment in a hospital between October 2023 and September 2024 were selected and divided into a control group and an observation group using the mean score method,each with 36 cases.In the control group,traditional foreign body forceps combined with laparoscopic resection were performed,and in the observation group,modified EMR and ESD were performed as needed.The mass resection rate,histologically intact resection rate,postoperative serum vascular endothelial growth factors(VEGFA,VEGFB,VEGFC levels)in the postoperative period of 7d,and indicators of the rate of related complications of the two groups of patients were compared.Results:The mass resection rate of 91.67%and histological complete resection rate of 94.44%in the observation group were significantly higher than those of 72.22%and 66.67%in the control group;the VEGFA,VEGFB,and VEGFC levels of the observation group were 82.08±7.94 ng/ml,168.89±16.53 ng/ml,and 121.07±10.75 ng/ml,respectively,in the postoperative period of 7 d after surgery;the levels were significantly higher than those of the control group:68.39±6.82 ng/ml,141.06±14.12 ng/ml,and 98.45±9.87 ng/ml,respectively,and the difference was statistically significant(P<0.05);the patients in the observation group had a lower rate of surgical complications than those in the control group(2.78%vs 8.33%),the difference was not statistically significant(P>0.05).Conclusion:Modified EMR and ESD in rectal neuroendocrine tumors are effective,not only can it effectively improve the rate of mass resection and histological integrity of the resection rate,but it can also further improve the level of serum vascular endothelial growth factor(VEGFA,VEGFB,VEGFC);thus,it is recommended to be promoted for use in clinical practice.展开更多
BACKGROUND To observe the endoscopic and pathological characteristics of laterally spreading tumors(LSTs)and explore the risk factors for carcinogenesis and submucosal infiltration.AIM To analyze the clinicopathologic...BACKGROUND To observe the endoscopic and pathological characteristics of laterally spreading tumors(LSTs)and explore the risk factors for carcinogenesis and submucosal infiltration.AIM To analyze the clinicopathological features of colorectal LSTs treated endoscopically and determine risk factors associated with carcinogenesis and submucosal invasion,providing evidence-based guidance for optimal treatment strategy selection.METHODS This study retrospectively analyzed the sex,age,and endoscopic and pathological features of patients who underwent endoscopic treatment for colorectal LSTs in our hospital from January 2021 to July 2024.Single-factor analysis was used to identify the risk factors for cancer and submucosal infiltration,and the factors with statistical significance were included in multivariate logistic regression analysis.RESULTS A total of 422 patients,including 224 males and 198 females,aged 63.45±9.23 years,were included.There were 456 LST lesions in total.The length of the endoscopically resected specimens was 3.01±0.48 cm,and the length of the lesions was 2.37±1.59 cm.It was located in 115 rectums(25.2%),40 sigmoid colon(8.8%),26 descending colon(5.7%),109 transverse colon(23.9%),112 ascending colon(24.6%),and 54 ileocecal regions(11.8%).Endoscopic submucosal dissection(ESD)was performed in 237 patients(52.0%),and endoscopic mucosal resection(EMR)was performed in 95 patients(20.8%).There were 113 EMR with precutting cases(24.8%),11 ESD with snare cases(2.4%),4 delayed bleeding cases and 5 intraoperative perforations.The pathological results revealed 119 cases of low-grade intraepithelial neoplasia(26.1%),221 cases of high-grade intraepithelial neoplasia(48.5%),82 cases of intramucosal carcinoma(18.0%),and 34 cases of submucous invasive carcinoma(7.5%).Multiple logistic regression analyses revealed that lesion size(>2 cm),lesion location(rectal)and endoscopic classification[false depressed tubulovillous adenoma(LST-NG pseudodepressed type,LST-NG-PD),type 1 particles(LST-G homogenous type),and LST-G nodular mixed type],accompanied by large nodules(with)were independent risk factors for carcinogenesis;endoscopic classification(LST-NG-PD)and the presence of large nodules were independent risk factors for submucosal infiltration.CONCLUSION These risk factors provide practical guidance for treatment selection:LST-NG-PD with large nodules should prioritize ESD,while high-risk rectal lesions>2 cm may require additional imaging evaluation before endoscopic resection.展开更多
BACKGROUND With the rising use of endoscopic submucosal dissection(ESD)and endoscopic mucosal resection(EMR),patients are increasingly questioning various aspects of these endoscopic procedures.At the same time,conver...BACKGROUND With the rising use of endoscopic submucosal dissection(ESD)and endoscopic mucosal resection(EMR),patients are increasingly questioning various aspects of these endoscopic procedures.At the same time,conversational artificial intelligence(AI)tools like chat generative pretrained transformer(ChatGPT)are rapidly emerging as sources of medical information.AIM To evaluate ChatGPT’s reliability and usefulness regarding ESD and EMR for patients and healthcare professionals.METHODS In this study,30 specific questions related to ESD and EMR were identified.Then,these questions were repeatedly entered into ChatGPT,with two independent answers generated for each question.A Likert scale was used to rate the accuracy,completeness,and comprehensibility of the responses.Meanwhile,a binary category(high/Low)was used to evaluate each aspect of the two responses generated by ChatGPT and the response retrieved from Google.RESULTS By analyzing the average scores of the three raters,our findings indicated that the responses generated by ChatGPT received high ratings for accuracy(mean score of 5.14 out of 6),completeness(mean score of 2.34 out of 3),and comprehensibility(mean score of 2.96 out of 3).Kendall’s coefficients of concordance indicated good agreement among raters(all P<0.05).For the responses generated by Google,more than half were classified by experts as having low accuracy and low completeness.CONCLUSION ChatGPT provided accurate and reliable answers in response to questions about ESD and EMR.Future studies should address ChatGPT’s current limitations by incorporating more detailed and up-to-date medical information.This could establish AI chatbots as significant resource for both patients and health care professionals.展开更多
BACKGROUND Duodenal mucosal ablation(DMA)using irreversible electroporation(IRE)with a glucagon-like peptide-1 receptor agonist has been clinically shown to reduce liver lipid deposition in non-alcoholic fatty liver d...BACKGROUND Duodenal mucosal ablation(DMA)using irreversible electroporation(IRE)with a glucagon-like peptide-1 receptor agonist has been clinically shown to reduce liver lipid deposition in non-alcoholic fatty liver disease(NAFLD).However,the specific metabolic contributions of DMA using IRE in NAFLD remain unclear.AIM To assess the feasibility and effectiveness of DMA using IRE in NAFLD rat models.METHODS Seven-week-old male Sprague-Dawley rats underwent DMA using IRE after 8 weeks on a high-fat diet.Two weeks post-treatment,duodenal and liver tissues and blood samples were collected.We evaluated differences in the duodenal wall structure,liver lipid deposition,enteroendocrine,claudin,and zonula ocludens-1 in the duodenal mucosa.RESULTS DMA using IRE could be safely performed in rats with NAFLD without duodenal bleeding,perforation,or stenosis.The duodenum healed well 2 weeks after DMA and was characterized by slimmer villi,narrower and shallower crypts,and thicker myenterons compared with the sham-control setting.Liver lipid deposition was reduced and serum lipid index parameters were considerably improved in the DMA setting.However,these improvements were independent of food intake and weight loss.In addition,enteroendocrine parameters,such as claudin,and zonula ocludens-1 levels in the duodenal mucosa,differed between the different settings in the DMA group.CONCLUSION By altering enteroendocrine and duodenal permeability,simple DMA using IRE ameliorated liver lipid deposition and improved serum lipid parameters in NAFLD rats.展开更多
基金supported by National Key Basic Research Program of China(2013CB127300)Natural Science Foundation of China(31430082).
文摘Background:High-protein diets can increase the colonic health risks.A moderate reduction of dietary crude-protein(CP)level can improve the colonic bacterial community and mucosal immunity of pigs.However,greatly reducing the dietary CP level,even supplemented with all amino acids(AAs),detrimentally affects the colonic health,which may be due to the lack of protein-derived peptides.Therefore,this study evaluated the effects of supplementation of casein hydrolysate(peptide source)in low-protein(LP)diets,in comparison with AAs supplementation,on the colonic microbiota,microbial metabolites and mucosal immunity in pigs,aiming to determine whether a supplementation of casein hydrolysate can improve colonic health under very LP level.Twenty-one pigs(initial BW 19.90±1.00 kg,63±1 days of age)were assigned to three groups and fed with control diet(16%CP),LP diets(13%CP)supplemented with free AAs(LPA)or casein hydrolysate(LPC)for 4 weeks.Results:Compared with control diet,LPA and LPC diet decreased the relative abundance of Streptococcus and Escherichia coli,and LPC diet further decreased the relative abundance of Proteobacteria.LPC diet also increased the relative abundance of Lactobacillus reuteri.Both LP diets decreased concentrations of ammonia and cadaverine,and LPC diet also reduced concentrations of putrescine,phenol and indole.Moreover,LPC diet increased total short-chain fatty acid concentration.In comparison with control diet,both LP diets decreased protein expressions of Toll-like receptor-4,nuclear factor-κB,interleukin-1βand tumor necrosis factor-α,and LPC diet further decreased protein expressions of nucleotide-binding oligomerization domain protein-1 and interferon-γ.LPC diet also increased protein expressions of G-protein coupled receptor-43,interleukin-4,transforming growth factor-β,immunoglobulin A and mucin-4,which are indicators for mucosal defense activity.Conclusions:The results showed that supplementing casein hydrolysate showed beneficial effects on the colonic microbiota and mucosal immunity and barrier function in comparison with supplementing free AAs in LP diets.These findings may provide new framework for future nutritional interventions for colon health in pigs.
基金supported by the National Key R&D Program of China(2021YFD1300403)the Major Program of Heilongjiang Province of China(2021ZX12B08-02).
文摘Background Cold regions have long autumn and winter seasons and low ambient temperatures.When pigs are unable to adjust to the cold,oxidative damage and inflammation may develop.However,the differences between cold and non-cold adaptation regarding glucose and lipid metabolism,gut microbiota and colonic mucosal immunological features in pigs are unknown.This study revealed the glucose and lipid metabolic responses and the dual role of gut microbiota in pigs during cold and non-cold adaptation.Moreover,the regulatory effects of dietary glucose supplements on glucose and lipid metabolism and the colonic mucosal barrier were evaluated in cold-exposed pigs.Results Cold and non-cold-adapted models were established by Min and Yorkshire pigs.Our results exhibited that cold exposure induced glucose overconsumption in non-cold-adapted pig models(Yorkshire pigs),decreasing plasma glucose concentrations.In this case,cold exposure enhanced the ATGL and CPT-1αexpression to promote liver lipolysis and fatty acid oxidation.Meanwhile,the two probiotics(Collinsella and Bifidobacterium)depletion and the enrichment of two pathogens(Sutterella and Escherichia-Shigella)in colonic microbiota are not conducive to colonic mucosal immunity.However,glucagon-mediated hepatic glycogenolysis in cold-adapted pig models(Min pigs)maintained the stability of glucose homeostasis during cold exposure.It contributed to the gut microbiota(including the enrichment of the Rikenellaceae RC9 gut group,[Eubacterium]coprostanoligenes group and WCHB1-41)that favored cold-adapted metabolism.Conclusions The results of both models indicate that the gut microbiota during cold adaptation contributes to the protection of the colonic mucosa.During non-cold adaptation,cold-induced glucose overconsumption promotes thermogenesis through lipolysis,but interferes with the gut microbiome and colonic mucosal immunity.Furthermore,glucagon-mediated hepatic glycogenolysis contributes to glucose homeostasis during cold exposure.
基金supported by the National Natural Science Foundation of China(31872362 and 32072688)the Agricultural Science and Technology Independent Innovation Fund Project of Jiangsu Province[CX(19)1006].
文摘Background:Lactic acid bacteria(LAB)participating in milk fermentation naturally release and enrich the fermented dairy product with a broad range of bioactive metabolites,which has numerous roles in the intestinal health-promot-ing of the consumer.However,information is lacking regarding the application prospect of LAB fermented milk in the animal industry.This study investigated the effects of lactic acid bacteria-fermented formula milk(LFM)on the growth performance,intestinal immunity,microbiota composition,and transcriptomic responses in weaned piglets.A total of 24 male weaned piglets were randomly divided into the control(CON)and LFM groups.Each group consisted of 6 replicates(cages)with 2 piglets per cage.Each piglet in the LFM group were supplemented with 80 mL LFM three times a day,while the CON group was treated with the same amount of drinking water.Results:LFM significantly increased the average daily gain of piglets over the entire 14 d(P<0.01)and the average daily feed intake from 7 to 14 d(P<0.05).Compared to the CON group,ileal goblet cell count,villus-crypt ratio,sIgA,and lactate concentrations in the LFM group were significantly increased(P<0.05).Transcriptomic analysis of ileal mucosa identified 487 differentially expressed genes(DEGs)between two groups.Especially,DEGs involved in the intestinal immune network for IgA production pathways,such as polymeric immunoglobulin receptor(PIGR),were significantly up-regulated(P<0.01)by LFM supplementation.Moreover,trefoil factor 2(TFF2)in the LFM group,one of the DEGs involved in the secretory function of goblet cells,was also significantly up-regulated(P<0.01).Sequenc-ing of the 16S rRNA gene of microbiota demonstrated that LFM led to selective enrichment of lactate-producing and short-chain fatty acid(SCFA)-producing bacteria in the ileum,such as an increase in the relative abundance of Entero-coccus(P=0.09)and Acetitomaculum(P<0.05).Conclusions:LFM can improve intestinal health and immune tolerance,thus enhancing the growth performance of weaned piglets.The changes in microbiota and metabolites induced by LFM might mediate the regulation of the secretory function of goblet cells.
基金supported by Science and Technology Commission of Shanghai Municipality(No.17ZR1406600)National Science Foundation of China(No.21577037)sponsored by Science and Technology Commission of Shanghai Municipality(No.10DZ2220500 and No.11DZ2260600)
文摘A novel oral protein delivery system with enhanced intestinal penetration and improved antigen stability based on chitosan(CS) nanoparticles and antigen-cyclodextrin(CD) inclusion complex was prepared by a precipitation/coacervation method. Ovalbumin(OVA) as a model antigen was firstly encapsulated by cyclodextrin, either β-cyclodextrin( β-CD) or carboxymethyl-hydroxypropyl-β-cyclodextrin(CM-HP-β-CD) and formed OVA-CD inclusion complexes, which were then loaded to chitosan nanoparticles to form OVA loaded β-CD/CS or CM-HP-β-CD/CS nanoparticles with uniform particle size(836.3 and 779.2 nm, respectively) and improved OVA loading efficiency(27.6% and 20.4%, respectively). In vitro drug release studies mimicking oral delivery condition of OVA loaded CD/CS nanoparticles showed low initial releases at p H 1.2 for 2 h less than 3.0% and a delayed release which was below to 30% at p H 6.8 for further 72 h. More importantly, after oral administration of OVA loaded β-CD/CS nanoparticles to Balb/c mice, OVA-specific sIgA levels in jejunum of OVA loaded β-CD/CS nanoparticles were 3.6-fold and 1.9-fold higher than that of OVA solution and OVA loaded chitosan nanoparticles, respectively. In vivo evaluation results showed that OVA loaded CD/CS nanoparticles could enhance its efficacy for inducing intestinal mucosal immune response. In conclusion, our data suggested that CD/CS nanoparticles could serve as a promising antigen-delivery system for oral vaccination.
文摘The 778th Xiangshan Science Conference,themed“Regional Immunity in the Lung and Respiratory Tract:Challenges and Opportunities”,convened in Beijing on April 8–9,2025.Co-chaired by four leading scientists-ProfessorGeorge FuGao(Institute of Microbiology,Chinese Academy of Sciences),Professor Chen Dong(Westlake University School of Medicine),Professor Zhigang Tian(University of Science and Technology of China).
基金supported by National Key Research and Development Program of China(2019YFC1605003-3)the Science and Technology Projects of Xiamen Science and Technology Bureau(3502Z20183034)。
文摘The numerous health benefits of olive oil are widely known,however,it also provides anti-allergic properties that have not yet been fully defined.In this study,the anti-allergic activity of olive oil was evaluated by analyzing the clinical symptoms and immune-related factors in BALB/c mice that had ingested600 mg/(kg·day)olive oil for two weeks prior to the evaluation.An allergy model was subsequently constructed for analysis,the results of which showed that the olive oil reduced the scores of allergic symptoms in the mice,and up-regulated the hypothermia and the decline in the immune organ index.Moreover,fewer allergy-related cytokines and reduced intestinal inflammation was discovered in the olive oil-treated group.In addition,analysis of intestinal mucosal immune-related factors revealed that the olive oil promoted the expression of intestinal tight junction proteins(Claudin-1,Occludin,and ZO-1)and IL-22,and helped maintain the integrity of the intestinal epithelial physical barrier.Increased levels of mucin 2 andβ-defensin were also found in the intestinal mucus of the olive oil-treated mice.These findings suggest that the oral administration of olive oil effectively attenuated the ovalbumin-induced allergic immune response in the mice,and had a positive effect on intestinal epithelial mucosal immunity.
基金National Key Research and Development Program of China(No.2018YFD0200100)Jiangsu Provincial Six Talent Peaks Project(No.XCL-090)Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)。
文摘Selenium doped carbon(Se/C),an easily fabricated material,was found to be bio-active and it can serve as an adjuvant to enhance the immune effect of Tween 80/Brij 30(T80/B30)vesicles and Tween 80/polymer cationic surfactant PN320(T80/PN320)mixed micelles.The synergistic effect of the combination of T80/B30 vesicles and T80/PN320 mixed micelles with Se/C on nasal mucosal immunity was studied in this work,which might provide theoretical basis for developing the related new adjuvant for nasal immunization of recombinant protein,peptide and split protein vaccine.Since both selenium and carbon were bio-compatible elements,Se/C might be safe for practical applications,and this was also reflected by the low hemolytic activity of the materials.This work not only reports an efficient protocol for adjuvant development,but also significantly expands the application scope of selenium chemistry.
基金National Natural Science Foundation of China(31602099)Key Laboratory of Prevention and Control Agents for Animal Bacteriosis(Ministry of Agriculture)(KLPCAAB-2018-06)the Engineering Research Center of Ecology and Agricultural Use of Wetland,Ministry of Education(KF201913)。
文摘[Objectives]The aim of this study was to investigate the effects of APS-sEPS(a polysaccharide compound of Astragalus polysaccharides and sulfated Epimedium polysaccharide)on intestinal mucosal immunity and structural morphology.[Methods]Firstly,the diarrhea model was established using the optimal dose of magnesium sulfate in mice.Then,the diarrhea mice were randomly divided into three groups and given either physiological saline(diarrhea model group)or injected with APS-sEPS or APS.The normal mice were selected as a control group.After administration,the duodenum,jejunum and ileum were processed microtome section,and observed for describing the small intestine morphology,villus height and crypt depth.The tissue homogenates of the duodenum,jejunum and ileum were gathered to detect the changes of sIgA,IL-4 and IL-10.[Results]The results indicated that APS-sEPS could effectively relieve diarrhea in mice.In the APS-sEPS group,the villus heights of duodenum,jejunum and ileum were increased and the depth of crypt was reduced.The contents of IL-4,IL-10 and sIgA in jejunum and ileum in APS-sEPS group were significantly higher than that in the control group(P<0.05).[Conclusions]These results indicated that APS-sEPS promoted the recovery of intestinal morphological structure and enhanced the mucosa immunity of the small intestine.
文摘Endoscopic submucosal dissection(ESD)has emerged as a pivotal therapeutic modality for early gastrointestinal(GI)cancers,providing a minimally invasive approach with curative potential.This technique enables the en bloc resection of neoplastic lesions confined to the mucosa and submucosa,thereby preserving organ function and reducing the need for more radical surgical interventions.ESD provides diagnostic clarity and enhances patient survival rates when performed by skilled practitioners in the early stages of GI cancers such as esophageal,gastric,and colorectal carcinomas.This article examines the indications,procedural advancements,technical considerations,and outcomes associated with ESD in early GI cancers.The challenges and complications that can arise are also highlighted.Additionally,we discuss the evolving role of novel techniques and adjunctive therapies to improve safety and efficacy.As the field progresses,ESD remains a cornerstone in managing early GI cancers,offering patients a promising option for organ preservation and long-term survival.
基金supported by the National Natural Science Foundation of China (30670097)National Basic Research Program of China (973 Program) (2005CB522903)+1 种基金National Key R&D Program (2007BAI28B04)National S&T Major Project on Major Infectious Diseases (2008ZX10001-010)from the Ministry of Science and Technology of the People’s Republic of China
文摘Severe Acute Respiratory Syndrome （SARS） is a deadly infectious disease caused by SARS Coronavirus （SARS-CoV）. Inactivated SARS-CoV has been explored as a vaccine against SARS-CoV. However, safe and potent adjuvants, especially with more efficient and economical needle-free vaccination are alw needed more urgently in a pandemic. The development of a safe and effective mucosal adjuvant and vaccine ays for prevention of emergent infectious diseases such as SARS will be an important advancement. PIKA, a stabilized derivative of Poly （I：C）, was previously reported to be safe and potent as adjuvant in mouse models. In the present study, we demonstrated that the intraperitoneal and intranasal co-administration of inactivated SARS-CoV vaccine together with this improved Poly （I：C） derivative induced strong anti-SARS-CoV mucosal and systemic humoral immune responses with neutralizing activity against pseudotyped virus. Although intraperitoneal immunization of inactivated SARS-CoV vaccine alone could induce a certain level of neutralizing activity in serum as well as in mucosal sites, co-administration of inactivated SARS-CoV vaccine with PIKA as adjuvant could induce a much higher neutralizing activity. When intranasal immunization was used, PIKA was obligatorily for inducing neutralizing activity in serum as well as in mucosal sites and was correlated with both mucosal IgA and mucosal IgG response. Overall, PIKA could be a good mucosal adjuvant candidate for inactivated SARS-CoV vaccine for use in possible future pandemic.
文摘Objective To explore the role of curcumin(Cur)in improving IgA nephropathy(IgAN)and its related mechanisms.Methods Fifty 7-month-old miR-23b knockout(miR-23b^(-/-))mice weighing(25±5)g were used to establish an IgAN disease model,and were randomly divided into IgAN group,IgAN+Cur(150 mg/kg)group and IgAN+Cur(300 mg/kg)group using simple randomisation.
文摘Microbes play a critical role in shaping immune development,with growing interest in how rhinovirus(RV)interacts with the host immune system,particularly in individuals with asthma and chronic obstructive pul-monary disease(COPD).Disruptions in microbial balance during RV infections can impair immune homeostasis and worsen disease outcomes.Recent studies emphasize RV-induced regulation of antiviral defenses,cytokine production,and immune tolerance.This review explores the interplay between RV,the immune system,and microbiota,highlighting the importance of these interactions in guiding effective therapies for respiratory in-fections.It advances existing literature by considering microbiota-mediated therapies as a novel approach to managing RV exacerbations in respiratory diseases like asthma and COPD.
文摘BACKGROUND Underwater endoscopic mucosal resection(UEMR)has been shown to be a good treatment option for the management of nonpedunculated polyps≥10 mm since its introduction.However,there is a paucity of randomized controlled trials(RCTs)in Asia.AIM To compare the efficacy and safety of UEMR with those of conventional EMR(CEMR)in treating nonpedunculated colorectal lesions.METHODS We carried out this RCT at a tertiary hospital from October 2022 to July 2024.Patients with nonpedunculated colorectal neoplasms ranging from 10 mm to 30 mm in size were randomly assigned to either the UEMR or CEMR group.The primary outcome was the curative resection(R0)rate.The secondary outcomes included en bloc resection,procedure time,adverse events,and the number of clips used for defect closure.RESULTS A total of 260 patients with 260 lesions(130 in each UEMR and CEMR group)were recruited.The median age was 58(27-85)years,the male/female ratio was 1.74,and the median lesion size was 20(10-30 mm)mm.Compared with CEMR,UEMR was associated with a significantly greater curative resection(R0)rate(98.4%vs 90.3%;P=0.007),greater en bloc resection rate(100%vs 94.6%;P=0.014),shorter procedure time(65 vs 185 seconds;P<0.001),lower rate of bleeding complications(1.5%vs 10%;P=0.003),and fewer clips used(2 vs 3;P<0.001).No perforations were observed in either group.CONCLUSION Compared with CEMR,UEMR has a higher R0 rate,greater en bloc resection rate,shorter procedure time,fewer bleeding complications,and clips used in the management of nonpedunculated colorectal neoplasms.
基金supported by the National Natural Science Foundation of China(82325012)the Youth Fund of the National Natural Science Foundation of China(82301043)+1 种基金the Natural Science Basic Research Program of Shaanxi (Program No.2024JC-YBQN-0980)the Shaanxi Key Scientific and Technological Innovation Team(2020TD-033).
文摘Hypoxemia is a common pathological state characterized by low oxygen saturation in the blood.This condition compromises mucosal barrier integrity particularly in the gut and oral cavity.However,the mechanisms underlying this association remain unclear.This study used periodontitis as a model to investigate the role of platelet activation in oral mucosal immunopathology under hypoxic conditions.Hypoxia upregulated methyltransferase-like protein 4(METTL4)expression in platelets,resulting in N6-methyladenine modification of mitochondrial DNA(mtDNA).This modification impaired mitochondrial transcriptional factor A-dependent cytosolic mtDNA degradation,leading to cytosolic mtDNA accumulation.Excess cytosolic mt-DNA aberrantly activated the cGAS-STING pathway in platelets.This resulted in excessive platelet activation and neutrophil extracellular trap formation that ultimately exacerbated periodontitis.Targeting platelet METTL4 and its downstream pathways offers a potential strategy for managing oral mucosa immunopathology.Further research is needed to examine its broader implications for mucosal inflammation under hypoxic conditions.
基金Clinical Study on Endoscopic Resection of Colorectal Submucosal Tumors Using Underwater Combined with Metal Clip-Assisted Snare,China(Grant No.2441ZF271)。
文摘Objective:To explore the clinical feasibility and safety of modified endoscopic mucosal resection for rectal neuroendocrine tumors(R-NETs).Methods:Seventy cases of R-NETs treated with endoscopic mucosal resection in our hospital between April 2022 and March 2024 were selected and divided into the control group and the observation group using the mean score method,each with 35 cases.In the control group,traditional endoscopic mucosal resection(EMR)was performed,and in the observation group,modified EMR(endoscopic mucosal resection with ligation apparatus[EMR-L])was performed.The operation time,hospitalization time,operation cost,and related complication rate of the two groups of patients were compared.Results:The operation time(20.36±1.46 min)and hospital stay(3.37±0.51 d)of patients in the observation group were shorter than those of the control group(31.44±2.65 min and 4.73±0.49 d).The cost of the operation in the observation group(7,695.85±1,521.42 yuan)was lower than that of the control group(8,418.62±1219.30 yuan),and the difference was statistically significant(P<0.05).The total incidence of postoperative related complications in the observation group was observed to be 11.42%,which was significantly lower than that of 31.42%in the control group,and the difference was statistically significant(P<0.05).Conclusion:The application of modified EMR in R-NETs is remarkable,which can not only effectively shorten the operation time and hospital stay,but also further reduce the risk of related complications,and indirectly save a large amount of hospital costs;thus,it is recommended to be promoted and applied clinically.
基金Supported by the Research Project of the Chinese Digestive Early Cancer Physicians’Joint Growth Program,No.GTCZ-2021-AH-34-0012.
文摘BACKGROUND Patients diagnosed with esophageal mucosal bridges often experience symptoms such as chest pain and dysphagia,which pose considerable challenges for endo-scopic surgical interventions.CASE SUMMARY We present a case involving early-stage esophageal cancer discovered in a resting room,notable for the rare manifestation of esophageal mucosal bridging.Following a comprehensive multidisciplinary discussion and the development of a treatment strategy,we proceeded with endoscopic submucosal dissection for the patient.During the procedure,we encountered operational challenges due to the presence of a diverticulum and a partial absence of the muscularis propria.To facilitate the retraction of a portion of the resected specimen,we utilized dental floss.Ultimately,we successfully excised the entire lesion.After a three-day period of fasting with a water-only diet,subsequent iodine water cholan-giography did not indicate any perforations,and the patient was advised to transition to a liquid diet.The patient was discharged five days post-operation.A follow-up endoscopy conducted three months later revealed scar-like changes in the mid-esophagus,with the patient reporting no significant discomfort.CONCLUSION In summary,although esophageal mucosal bridges are rarely documented,they should be considered in the differential diagnosis of mechanical dysphagia.Furthermore,endoscopic therapy represents a feasible approach for their mana-gement.
基金Clinical Study on Endoscopic Resection of Colorectal Submucosal Tumors Using Underwater Combined with Metal Clip-Assisted Snare,China(Grant No.2441ZF271)。
文摘Objective:To analyze the application value of modified endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)in rectal neuroendocrine tumors,with a view to providing new clinical options for the early diagnosis and treatment of patients with such tumors,and thus improving their prognosis.Methods:Seventy-two patients with rectal neuroendocrine tumors who underwent surgical treatment in a hospital between October 2023 and September 2024 were selected and divided into a control group and an observation group using the mean score method,each with 36 cases.In the control group,traditional foreign body forceps combined with laparoscopic resection were performed,and in the observation group,modified EMR and ESD were performed as needed.The mass resection rate,histologically intact resection rate,postoperative serum vascular endothelial growth factors(VEGFA,VEGFB,VEGFC levels)in the postoperative period of 7d,and indicators of the rate of related complications of the two groups of patients were compared.Results:The mass resection rate of 91.67%and histological complete resection rate of 94.44%in the observation group were significantly higher than those of 72.22%and 66.67%in the control group;the VEGFA,VEGFB,and VEGFC levels of the observation group were 82.08±7.94 ng/ml,168.89±16.53 ng/ml,and 121.07±10.75 ng/ml,respectively,in the postoperative period of 7 d after surgery;the levels were significantly higher than those of the control group:68.39±6.82 ng/ml,141.06±14.12 ng/ml,and 98.45±9.87 ng/ml,respectively,and the difference was statistically significant(P<0.05);the patients in the observation group had a lower rate of surgical complications than those in the control group(2.78%vs 8.33%),the difference was not statistically significant(P>0.05).Conclusion:Modified EMR and ESD in rectal neuroendocrine tumors are effective,not only can it effectively improve the rate of mass resection and histological integrity of the resection rate,but it can also further improve the level of serum vascular endothelial growth factor(VEGFA,VEGFB,VEGFC);thus,it is recommended to be promoted for use in clinical practice.
文摘BACKGROUND To observe the endoscopic and pathological characteristics of laterally spreading tumors(LSTs)and explore the risk factors for carcinogenesis and submucosal infiltration.AIM To analyze the clinicopathological features of colorectal LSTs treated endoscopically and determine risk factors associated with carcinogenesis and submucosal invasion,providing evidence-based guidance for optimal treatment strategy selection.METHODS This study retrospectively analyzed the sex,age,and endoscopic and pathological features of patients who underwent endoscopic treatment for colorectal LSTs in our hospital from January 2021 to July 2024.Single-factor analysis was used to identify the risk factors for cancer and submucosal infiltration,and the factors with statistical significance were included in multivariate logistic regression analysis.RESULTS A total of 422 patients,including 224 males and 198 females,aged 63.45±9.23 years,were included.There were 456 LST lesions in total.The length of the endoscopically resected specimens was 3.01±0.48 cm,and the length of the lesions was 2.37±1.59 cm.It was located in 115 rectums(25.2%),40 sigmoid colon(8.8%),26 descending colon(5.7%),109 transverse colon(23.9%),112 ascending colon(24.6%),and 54 ileocecal regions(11.8%).Endoscopic submucosal dissection(ESD)was performed in 237 patients(52.0%),and endoscopic mucosal resection(EMR)was performed in 95 patients(20.8%).There were 113 EMR with precutting cases(24.8%),11 ESD with snare cases(2.4%),4 delayed bleeding cases and 5 intraoperative perforations.The pathological results revealed 119 cases of low-grade intraepithelial neoplasia(26.1%),221 cases of high-grade intraepithelial neoplasia(48.5%),82 cases of intramucosal carcinoma(18.0%),and 34 cases of submucous invasive carcinoma(7.5%).Multiple logistic regression analyses revealed that lesion size(>2 cm),lesion location(rectal)and endoscopic classification[false depressed tubulovillous adenoma(LST-NG pseudodepressed type,LST-NG-PD),type 1 particles(LST-G homogenous type),and LST-G nodular mixed type],accompanied by large nodules(with)were independent risk factors for carcinogenesis;endoscopic classification(LST-NG-PD)and the presence of large nodules were independent risk factors for submucosal infiltration.CONCLUSION These risk factors provide practical guidance for treatment selection:LST-NG-PD with large nodules should prioritize ESD,while high-risk rectal lesions>2 cm may require additional imaging evaluation before endoscopic resection.
基金Supported by Ningbo Top Medical and Health Research Program,No.2023020612the Ningbo Leading Medical&Healthy Discipline Project,No.2022-S04+1 种基金the Medical Health Science and Technology Project of Zhejiang Provincial Health Commission,No.2022KY315Ningbo Science and Technology Public Welfare Project,No.2023S133.
文摘BACKGROUND With the rising use of endoscopic submucosal dissection(ESD)and endoscopic mucosal resection(EMR),patients are increasingly questioning various aspects of these endoscopic procedures.At the same time,conversational artificial intelligence(AI)tools like chat generative pretrained transformer(ChatGPT)are rapidly emerging as sources of medical information.AIM To evaluate ChatGPT’s reliability and usefulness regarding ESD and EMR for patients and healthcare professionals.METHODS In this study,30 specific questions related to ESD and EMR were identified.Then,these questions were repeatedly entered into ChatGPT,with two independent answers generated for each question.A Likert scale was used to rate the accuracy,completeness,and comprehensibility of the responses.Meanwhile,a binary category(high/Low)was used to evaluate each aspect of the two responses generated by ChatGPT and the response retrieved from Google.RESULTS By analyzing the average scores of the three raters,our findings indicated that the responses generated by ChatGPT received high ratings for accuracy(mean score of 5.14 out of 6),completeness(mean score of 2.34 out of 3),and comprehensibility(mean score of 2.96 out of 3).Kendall’s coefficients of concordance indicated good agreement among raters(all P<0.05).For the responses generated by Google,more than half were classified by experts as having low accuracy and low completeness.CONCLUSION ChatGPT provided accurate and reliable answers in response to questions about ESD and EMR.Future studies should address ChatGPT’s current limitations by incorporating more detailed and up-to-date medical information.This could establish AI chatbots as significant resource for both patients and health care professionals.
基金Supported by the National Key Research and Development Program,No.2023YFF0713700 and No.2023YFF0713705Common Technology R&D Platform of Shaanxi Province,No.2023GXJS-01-1-2the Cyrus Tang Foundation Chung Ying Young Scholars Program.
文摘BACKGROUND Duodenal mucosal ablation(DMA)using irreversible electroporation(IRE)with a glucagon-like peptide-1 receptor agonist has been clinically shown to reduce liver lipid deposition in non-alcoholic fatty liver disease(NAFLD).However,the specific metabolic contributions of DMA using IRE in NAFLD remain unclear.AIM To assess the feasibility and effectiveness of DMA using IRE in NAFLD rat models.METHODS Seven-week-old male Sprague-Dawley rats underwent DMA using IRE after 8 weeks on a high-fat diet.Two weeks post-treatment,duodenal and liver tissues and blood samples were collected.We evaluated differences in the duodenal wall structure,liver lipid deposition,enteroendocrine,claudin,and zonula ocludens-1 in the duodenal mucosa.RESULTS DMA using IRE could be safely performed in rats with NAFLD without duodenal bleeding,perforation,or stenosis.The duodenum healed well 2 weeks after DMA and was characterized by slimmer villi,narrower and shallower crypts,and thicker myenterons compared with the sham-control setting.Liver lipid deposition was reduced and serum lipid index parameters were considerably improved in the DMA setting.However,these improvements were independent of food intake and weight loss.In addition,enteroendocrine parameters,such as claudin,and zonula ocludens-1 levels in the duodenal mucosa,differed between the different settings in the DMA group.CONCLUSION By altering enteroendocrine and duodenal permeability,simple DMA using IRE ameliorated liver lipid deposition and improved serum lipid parameters in NAFLD rats.
