Abstract Background Endoscopic submucosal dissection (ESD) is a method that can be used for en bloc resection, regardless of the size and form of the lesion. The special location of ileocecal tumors leads to insufficient counter-traction and poor field of vision, making ESD difficult. An S-O clip has been developed to simplify the attachment procedure, eliminating interference with the endoscope and improving accessibility. Case presentation The patient was a 70-year-old man who presented with abdominal pain and bloating. A colonoscopy revealed a flat-elevated-type lesion on the ileocecal valve, with the oral side of the lesion having progressed to the terminal ileum. The traction direction was adjusted from distal to proximal during the procedure using the S-O clip. Finally, with the help of the S-O clip, the tumor was safely removed and collected. Conclusion The S-O clip was successful in ESD of a colorectal tumor. By removing and re-anchoring the loaded ring, the S-O clips allowed the adjustment of traction direction from distal to proximal during ESD.

BackgroundEarly gastric cancer (EGC) has a high survival rate, but it is difficult to diagnosis. Recently, artificial intelligence (AI) based on deep convolutional neural network (DCNN) has made significant progress in the field of gastroenterology. The purpose of this study was to establish a DCNN assist system to improve the detection of EGC.Methods3400 EGC and 8600 benign images were collected to train the DCNN to detect EGC. Subsequently, its diagnostic ability was compared to that of endoscopists using an independent internal test set (ITS, including 1289 images) and an external test set (ETS, including 542 images) come from three digestive center.ResultsThe diagnostic time of DCNN and endoscopists were 0.028s, 8.05 ± 0.21s, 7.69 ± 0.25s in ITS, and 0.028s, 7.98 ± 0.19s, 7.50 ± 0.23s in ETS, respectively. In ITS, the diagnostic sensitivity and accuracy of DCNN are 88.08%(95% confidence interval,95%CI,85.24%-90.44%), 88.60% (95%CI,86.74%-90.22%), respectively. In ETS, the diagnostic sensitivity and accuracy are 92.08% (95%CI, 87.91%- 94.94%),92.07%(95%CI, 89.46%-94.08%),respectively. DCNN outperformed all endoscopists in ETS, and had a significantly higher sensitivity than the junior endoscopists(JE)(by18.54% (95%CI, 15.64%-21.84%) in ITS, also higher than JE (by21.67%,95%CI, 16.90%-27.32%) and senior endoscopists (SE) (by2.08%, 95%CI, 0.75%-4.92%)in ETS. The accuracy of DCNN model was higher (by10.47%,95%CI, 8.91%-12.27%) than that of JE in ITS, and also higher (by14.58%,95%CI, 11.84%-17.81%; by 1.94%,95%CI,1.25%-2.96%, respectively) than JE and SE in ETS.ConclusionThe DCNN can detected more EGC images in a shorter time than the endoscopists. It will become an effective tool to assist in the detection of EGC in the near future.

OBJECTIVE To investigated the anti-tumor in vivo effect and mechanism of the acid RNA protein complex (FA-2-b-β) of Agaricus blazei Murrill extract. METHODS CCK-8 method was used to detected the inhibitory effect of FA-2-b-β on proliferation of primary CML cells from newly diagnosed CML patients, the CML mouse model was established by trail-venous injection of primary CML cells, and the survival time, blood cell count and body weight were observed, the immunoflouresence and immunehistochemistry analysis, RT-qPCR, Western bolt were used to detemine the expression of caspase-3 signal pathway-related apoptosis genes and proteins. RESULTS The experiments in vitro showed that the proliferative inhibitory rate in drug-treated group increased with concentration- and time-dependent manner (r24=0.9092, r48=0.9442, r72=0.9546), the inter group comparison showed the statistical difference of results. The experiments in vitro showed that the survival time prolonged, blood cell count increased and body weight recovered in FA-2-b-β-treated group and imatinib-treated group, despite the WBC count is still high. The RT-qPCR and Western blot showed that the expression of BAX and caspase-3 gene and protein were up-regulated, the expression of BCL-2, cytochroime C, caspase-8, caspase-9 and BCL-ABL gene and protein were down-regulated. CONCLUSION The FA-2-b-β can induce apoptosis of primary CML cells and prolong the survival time of CML model mouse, which may be related with the caspase-3 signal pathway related genes and proteins.

Agaricus blazei Murill (AbM) is a mushroom belonging to the Basidiomycetes family, which is believed to have antitumor and antioxidative activities. Proteoglycans and ergosterol are considered the key compounds of AbM for antitumor properties and so are used in complementary and alternative medicine as an anticancer drug. AbM is used to avoid serious side effects that would inevitably affect patients. Currently, the efficacy of AbM against chronic myeloid leukemia (CML) has not been established. The present study aimed to investigate the antitumor activities of the acidic RNA protein complex, FA-2-b-β, extracted from wild edible AbM. The CML K562 cells or primary CML bone marrow (BM) cells were treated with FA-2-b-β at different concentrations and time points. CML cell line proliferation and apoptosis were determined using the CCK-8 assay or Annexin V/propidium iodide (PI) labeling, RT-qPCR and western blotting was performed to determine the involvement of the Wnt/β-catenin-associated apoptotic pathway. The results of the present study demonstrated that FA-2-b-β has a high anti-proliferative potency and strong pro-apoptotic effects. Thus, daily intake of mushrooms containing FA-2-b-β may be an adequate source as an alternative medicine in the management of CML, and may provide useful information for the development of a novel therapeutic target in this area.

慢性乙型肝炎(CHB)已成为全球最关注的疾病之一,每年导致约100万人死于慢性乙型肝炎相关的肝硬化和肝细胞癌,抗病毒则成为慢性乙型肝炎治疗的关键.对于CHB患者,抗病毒治疗首先要实现对HBV的免疫学控制,进而阻止疾病的的进展.对于HBeAg阳性患者CHB患者,获得HBeAg血清学转换意味着达到免疫控制.近年来,干扰素(IFN)、核苷(酸)类似物(NUC)的抗病毒疗效已得到全球公认,同时不可避免地尤其是HBeAg阳性慢性乙型病毒感染患者,可能存在一些治疗过早或过于积极的问题.正确评估HBeAg阳性慢性乙型病毒感染的疾病阶段,选择最佳治疗时期,最好地运用这些药物,单独或联合或序贯治疗,最大程度地发挥它们的作用,从而保证高效、持久的应答,仍是值得关注与探讨的话题.

胃癌是世界最常见恶性肿瘤之一,除了与环境、饮食、社会经济等因素有关外,遗传因素也起着重要的作用.尽管有些基因在胃癌中已经确定,但胃癌的遗传因素尚未得到充分的认识.全基因组关联分析、拷贝数变异分析、二代基因测序技术提供了系统化的方法来识别癌症基因组所有的基因变异,特别是在突变检测领域.本文就胃癌目前遗传学研究现状作一简要综述.