The efficacy of full-thickness endoscopic resection of subepithelial tumors in the gastric cardia

BACKGROUND Gastric subepithelial tumors(SETs)may harbor potential malignancy.Although it is well recognized that large SETs should be resected,the precise treatment strategy remains controversial.Compared to surgical resection,endoscopic resection(ER)has many advantages;however,ER of SETs in the cardia is challenging.AIM To evaluate the safety and efficacy of endoscopic full-thickness resection(EFTR)for the treatment of gastric cardia SETs.METHODS We retrospectively reviewed data from all patients with SETs originating from the muscularis propria layer in the gastric cardia that were treated by EFTR or submucosal tunneling ER(STER)at Zhongshan Hospital Fudan University between November 2014 and May 2022.Baseline characteristics and clinical outcomes,including procedure times and complications rates,were compared between groups of patients receiving EFTR and STER.RESULTS A total of 171 tumors were successfully removed[71(41.5%)tumors in the EFTR and 100(58.5%)tumors in the STER group].Gastrointestinal stromal tumors(GISTs)were the most common SET.The en bloc resection rate was 100%in the EFTR group vs 97.0%in STER group(P>0.05).Overall,the EFTR group had a higher complete resection rate than the STER group(98.6%vs 91.0%,P<0.05).The procedure time was also shorter in the EFTR group(44.63±28.66 min vs 53.36±27.34,P<0.05).The most common major complication in both groups was electrocoagulation syndrome.There was no significant difference in total complications between the two groups(21.1%vs 22.0%,P=0.89).CONCLUSION EFTR of gastric cardia SETs is a very promising method to facilitate complete resection with similar complications and reduced operative times compared to STER.In cases of suspected GISTs or an unclear diagnosis,EFTR should be recommended to ensure complete resection.

m6A修饰在结直肠肿瘤发生发展中的研究进展及潜在治疗价值

近年来,作为表观遗传修饰的重要组成部分,DNA组学和蛋白质组学在肿瘤发生发展中的作用机制研究已取得一定突破,而研究者也将目光聚焦在RNA的修饰上.N6-甲基腺嘌呤(N6-methyladenosine,m6A)是真核生物mRNA中主要的内部表观遗传修饰,具有动态且可逆的特点.m6A分别受到甲基化酶(Writers)、去甲基化酶(Erasers)和优先识别m6A修饰的蛋白质(Readers)调控,进一步调节RNA运输、定位、翻译及降解等,在肿瘤的发生发展中发挥促癌或抑癌的作用,并且具有成为恶性肿瘤治疗靶点的潜力.本文将对m6A的生物学特征、m6A RNA的修饰调控机制、m6A RNA甲基化修饰在结直肠肿瘤发生发展中的作用和相关靶向治疗进行综述,旨在为进一步寻找生物标记物和治疗靶点提供依据.

Coexistent Kaposi sarcoma and post-transplant lymphoproliferative disorder in the same lymph nodes after pediatric liver transplantation:A case report

BACKGROUND Kaposi sarcoma and post-transplant lymphoproliferative disorder have been occasionally reported in post-liver transplant patients.However,the simultaneous occurrence of these two diseases in the same lymph nodes is very rare.CASE SUMMARY We report the case of a 19-mo-old boy,who presented with intermittent fever and enlarged cervical lymph nodes after liver transplantation.Six cervical lymph nodes were biopsied,and the histopathological examinations revealed multifocal hyperplasia of spindle cells around small blood vessels,extravasated erythrocytes,and heavy infiltration of plasma cells in the cortex and medulla of the lymph nodes.The immunohistochemical analyses of spindle cells revealed positive expression of CD34,CD31,erythroblast transformation-specific-related gene,friend leukemia integration 1,and human herpesvirus-8.The lymphoproliferative lesions expressed CD38,CD138,and multiple myeloma 1.Epstein-Barr encoded RNA in situ hybridization demonstrated Epstein-Barr virus-positive lymphoid cells.Finally,we diagnosed the coexistence of Kaposi sarcoma and post-transplant lymphoproliferative disorder(plasmacytic hyperplasia)in the same lymph nodes.Treatment strategy included anti-CD20 monoclonal antibody(rituximab)and discontinuation of the immunosuppressant therapies.Lymph node biopsies during follow-up examinations revealed lymphoid hyperplasia.CONCLUSION The rare coexistence of Kaposi sarcoma and post-transplant lymphoproliferative disorder in the same lymph nodes post-liver transplantation possibly associates with immunodeficiency and Epstein-Barr virus and human herpesvirus-8 coinfection.

Impact of cytomegalovirus infection on biliary disease after liver transplantation-maybe an essential factor

BACKGROUND Cytomegalovirus(CMV)infection is common in liver transplant(LT)_recipients,and biliary complications occur in a large number of patients.It has been reported that CMV-DNA is more detectable in bile than in blood.AIM To investigate the effects of CMV infection on biliary complications by comparing the levels of CMV-DNA in the bile and blood of patients after LT.METHODS We conducted a retrospective analysis of 57 patients who underwent LT,10 of these patients had no biliary complications and 47 patients had biliary complications.We also compared the levels of CMV-DNA in patients’bile and blood,which were sampled concurrently.We used RNAscope technology to identify CMV in paraffin-embedded liver sections.RESULTS CMV-DNA was not detected in bile samples and was detected in 2 blood samples from patients without biliary complications.In the 47 patients with biliary complications,CMV-DNA was detected in 22 bile samples and 8 blood samples,both bile and blood samples were positive for CMV-DNA in 6 patients.The identification rate of CMV-DNA in blood was 17.0%,and was 46.8%in bile.Moreover,tissue samples from 4 patients with biliary complications tested positive using RNAscope technology but were negative with hematoxylin and eosin staining.During the follow-up period,graft failure occurred in 13 patients with biliary complications,8 of whom underwent retransplantation,and 3 died.CMV-DNA in bile was detected in 9 of 13 patients with graft failure.CONCLUSION In patients with biliary complications,the identification rate of CMV-DNA in bile was higher than that in blood.Blood CMV-DNA negative patients with biliary complications should still be monitored for CMV-related biliary tract diseases.Potential occult CMV infection may also be a contributing etiological factor in the development of graft failure.

The impact of the COVID-19 outbreak on Australia’s public health and medical industry in 2020

In 2020,the sudden new crown(COVID-19)virus swept the world.Countries have adopted different epidemic prevention measures.The COVID-19 has brought an extraordinary impact on the economic and social health of all countries.Australia,located in the southern hemisphere,promptly adopted the closure and other epidemic prevention policies in late January.The whole people mobilized to actively fight against the epidemic.Compared with the passive immunization of developed countries such as the United Kingdom and the United States,it has experienced several twists and turns and achieved relatively successful results.However,the epidemic has profoundly affected public health and medical care.They are mainly manifested in mental and psychological,hand hygiene,respiratory diseases,surgical spectrum,cancer screening,and changes in national leadership’s response methods and medical insurance policies.Australia’s early physical distancing measures,relatively high per capita testing rates,political stability,national wealth and geographic isolation are among the explanatory factors.The country’s response to the COVID-19 pandemic has,thus far,been among the most successful in the world.

Current status and innovation attempt of compiling textbooks of Chinese medicine in medical colleges in China

At present,there are two modes in the compilation of textbooks of traditional Chinese medicine,one is stuck in one's own way and the other is to copy Western medicine completely.The reason is that the textbooks of traditional Chinese medicine colleges and universities are reduced into a hodger with no purpose,or the other is to cater to Western medicine system and give up the academic system of traditional Chinese medicine and lose the essence of traditional Chinese medicine.Through the"diagnosis and treatment strategy"and"knowledge link"of the new Chinese medicine textbooks,the author tries to make a breakthrough in the compilation,and puts forward the compilation ideas of rectifying the position of Chinese medicine textbooks,starting from the learning thinking of Western medicine students,and reflecting the characteristics of Chinese medicine and modern research results.

White matter connection's damage,not cortical activation, leading to language dysfunction of mitochondrial encephalomyopathy with lactic acidosis and strokelike episodes

Mitochondrial encephalomyopathy with lactic acidosis and strokelike episodes (MELAS) is a metabolic disorder characterized by hyperlactic acidemia and stroke-like symptoms.

HTRA1-related autosomal dominant cerebral small vessel disease

Background:Homozygous or compound heterozygous mutations in high temperature requirement serine peptidase A1(HTRA1)gene are responsible for cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy(CARASIL).Recently,increasing evidence has shown that heterozygous HTRA1 mutations are also associated with cerebral small vessel disease(CSVD)with an autosomal dominant pattern of inheritance.This study was aimed to analyze the genetic and clinical characteristics of HTRA1-related autosomal dominant CSVD.Methods:We presented three new Chinese cases of familial CSVD with heterozygous HTRA1 mutations and reviewed all clinical case reports and articles on HTRA1-related autosomal dominant CSVD included in PUBMED by the end of March 1,2020.CARASIL probands with genetic diagnosis reported to date were also reviewed.The genetic and clinical characteristics of HTRA1-related autosomal dominant CSVD were summarized and analyzed by comparing with CARASIL.Results:Forty-four HTRA1-related autosomal dominant CSVD probands and 22 CARASIL probands were included.Compared with typical CARASIL,HTRA1-related autosomal dominant probands has a higher proportion of vascular risk factors(P<0.001),a later onset age(P<0.001),and a relatively slower clinical progression.Alopecia and spondylosis can be observed,but less than those in the typical CARASIL.Thirty-five heterozygous mutations in HTRA1 were reported,most of which were missense mutations.Amino acids located close to amino acids 250-300 were most frequently affected,followed by these located near 150∼200.While amino acids 250∼300 were also the most frequently affected region in CARASIL patients,fewer mutations precede the 200th amino acids were detected,especially in the Kazal-type serine protease domain.Conclusions:HTRA1-related autosomal dominant CSVD is present as a mild phenotype of CARASIL.The trend of regional concentration of mutation sites may be related to the concentration of key sites in these regions which are responsible for pathogenesis of HTRA1-related autosomal dominant CSVD.

The offline data quality monitoring of the BESIII end-cap TOF system

Background The end-cap time-of-flight(TOF)at Beijing Spectrometer was upgraded with multi-gap resistive plate chamber technology in order to improve the particle identification capability in 2015.The offline data quality monitoring(ODQM)is a critical aspect of the data processing chain aiming at providing data with good quality for physics analyses.Method An ODQM tool for upgraded end-cap TOF has been developed to provide feedback about the functioning and performance of detector hardware and data processing chain.Detector information and reconstructed time-of-flight characteristics of charged tracks are filled into plots using full Bhabha events’reconstruction results,and then,these plots are used to assess the operational conditions of the detector and the quality of the data by the experts.Result This paper describes the design and the content of performance of the ODQM of end-cap TOF and the data quality performance achieved during the last 2-year physical data taking.

The offline data quality monitoring of the BESIII end cap TOF system

Purpose The end cap time of flight(TOF)at Beijing spectrometer was upgraded with multi-gap resistive plate chamber technology in order to improve the particle identification capability in 2015.The offline data quality monitoring is a critical aspect of the data processing chain aiming at providing data with good quality for physics analyses.Methods An offline data quality monitoring tool for upgraded end cap TOF has been developed to provide feedback about the functioning and performance of detector hardware and data processing chain.Results Detector information and reconstructed time-of-flight characteristics of charged tracks are filled into plots using full Bhabha events reconstruction results,and then,these plots are used to assess the operational conditions of the detector and the quality of the data by the experts.Conclusion This paper is describing the design and the content of performance of the offline data quality monitoring of end cap TOF and the data quality performance achieved during last 2 years’physical data taking.

Correction to:The offline data quality monitoring of the BESIII end-cap TOF system

Correction to:Radiation Detection Technology and Methods(2019)3:58 https://doi.org/10.1007/s41605-019-0132-0;(2021)5:207–212 https://doi.org/10.1007/s41605-021-00251-y The articles https://doi.org/10.1007/s41605-019-0132-0,https://doi.org/10.1007/s41605-021-00251-y have been inadvertently got published twice and were included in Volume 3 Issue 4(2019),Volume 5 issue 2(2021)Both articles are similar and the Publisher apologizes to the authors and readers for the inconvenience caused by this error.