BACKGROUND Growing evidence indicates that survival is correlated with immune status in certain types of solid tumors. The immune system functions either to eliminate cancer cells or to keep cancer cells in check by maintaining an equilibrium; if there is a malfunction in the immune system, immune escape may happen which then allows cancer cells to grow into clinically apparent tumors. The progression of the tumor leads to a poor prognosis. Regulatory T cells (Tregs), a subset of CD4+ T cells plays a pivotal role in regulating the immune system. Tregs were identified as being CD4+ T cells expressing high levels of CD25. The purpose of this study was to investigate the influence of the proportion of pretreatment regulatory T cells (CD45+CD4+CD25HICD127LOW) on the prognosis of patients with non-operative chemoradiotherapy for esophageal cancer (EC). METHODS A total of 297 patients with non-operative chemoradiotherapy EC treated at the Shanxi Province Cancer Hospital from January 2015 to January 2020 were included in the study. The correlation between regulatory T cell proportion and clinicopathological characteristics was analyzed by the chi-square test, while univariate survival analysis was carried out using the Kaplan-Meier method. Independent prognostic factors for overall survival (OS) were determined by univariate and multivariate Cox proportional regression models. RESULTS Of the clinicopathological features analyzed, tumor location and the proportion of CD4+CD8+ double-positive cells were significantly associated (P<0.05) with the proportion of pretreatment regulatory T cells. An assessment of the prognoses showed that patients with a high proportion of regulatory T cells had a significantly worse OS than patients with a low proportion of regulatory T cells. The OS of patients with a low proportion CD4+CD8+ cells was lower than that of patients with a high proportion of CD4+CD8+ cells. A high proportion of CD4+CD8+ (>3.45%) cells and a low proportion of regulatory T cells (≤5.15%) would have better OS before chemoradiotherapy. CONCLUSIONS Regulatory T cells play a role in predicting the prognosis of patients with EC before chemoradiotherapy.

BACKGROUND:Data on the experience of endoscopic retrograde cholangiopancreatography (ERCP) in the management of pancreaticobiliary maljunction (PBM) is limited.METHODS:A retrospective review of patients with PBM who underwent therapeutic ERCP at our endoscopy center between January 2008 and January 2016 was performed. Demographic, clinical, radiological and endoscopic data was documented. Patients who underwent sphincterotomy were divided into dilated group and undilated group based on their common channel diameter.RESULTS:Sixty-three PBM patients underwent 74 ERCP procedures. The technical success rate was 97.3%. ERCP therapy significantly decreased the levels of elevated liver enzymes and bilirubin. After an average of 27 months follow-up, 7 patients (11.1%) were lost. The overall effective rate of ERCP therapy was 60.7% (34/56). Decline in severity and frequency of abdominal pain was significant. Procedure-related complications were observed in 5 (6.8%) cases. Between the dilated group and undilated group, no significant difference was observed in effective rate, adverse events and follow-up results.CONCLUSIONS:ERCP can serve as a transitional step to stabilize PBM patients before definitive surgery. PBM patients with undilated common channel could benefit from sphincterotomy as well as those with dilated common channel.

Backgrounds and aims: This study aimed to compare the esophageal motility between gastroesophageal reflux disease (GERD) patients with typical symptoms but without globus sensation and GERD patients only with globus symptoms. Methods: A total of 57 consecutive GERD patients diagnosed by endoscopy or by 24-hour pH monitoring between May 2013 and September 2015 were included retrospectively into the study. The patients were grouped based on the presence or absence of globus. Thirty patients presented with typical reflux symptoms but without globus were assigned to the typical GERD group and 27 patients only with globus symptom were assigned to the globus GERD group. All patients underwent esophageal high resolution manometry (HRM) and the differences in esophageal motility between the two groups were analyzed. Results: The globus GERD group showed a significantly greater lower esophageal sphincter (LES) length, LES basal pressure and upper esophageal sphincter (UES) residual pressure than that of the typical GERD group (3.47 ± 0.76 vs 2.65 ± 0.62 cm, 21.71 ± 9.68 vs 16.04 ± 8.49 mmHg, 7.30 ± 4.42 vs 4.12 ± 2.92 mmHg, all p < 0.05). There was no significant difference between the two groups in terms of the distal wave amplitude, mean wave duration, distal contractile integral (DCI), contractile front velocity (CFV), distal latency (DL), integrated relaxation pressure (IRP) and UES basal pressure. The incidence of esophageal dysmotility in the globus GERD group (33.3%) was higher than in the typical GERD group (23.3%). There was no significant difference in esophageal acid exposure of the non-erosive gastroesophageal reflux disease (NERD) patients between the two groups. Conclusions: Globus GERD patients have a higher UES residual pressure, longer LES length, higher LES basal pressure and greater esophageal dysmotility than typical GERD patients. HRM is useful in evaluating esophageal motility of GERD patients.

Objective To evaluate the feasibility and acceptability of magnetically guided capsule endoscopy (MCE) as a screening or diagnostic means for upper gastrointestinal diseases.Methods One hundred and forty six patients underwent MCE during October 2013 to September 2014.All patients and endoscopists received a feedback survey with a self-administrated questionnaire;the items included the satisfaction of patients and endoscopists,the endoscopic image score,examination results,the endoscopy completion and operation time.Results Among 146 patients,145 completed MCE examination with a completion rate of 99.3％ (145/146).The operation time of MCE was (15.20 ± 4.85) min.The score of patient and endoscopist satisfaction was both 4,and patient tolerance score was 0.The divergence rate score was 3;the cleaness score of stomach was 3;and the vision relative definition was 79.31 ± 14.16.The most common examination result was chronic superficial gastritis (67/145,46.2％),followed by bile reflex gastritis (48/145,33.1％),normal stomach (39/145,26.9％),gastric polyps (20/145,13.8％),chronic atrophic gastritis (18/145,12.4％),bleeding from erosive gastritis (14/145,9.7％),reflux esophagitis (6/145,4.1％),2.7％ (4/145),gastrointestinal ulcer,(3/145,2.1％),upper gastrointestinal cancer (2/145),duodenal bulb inflammation (2/145),yellow melanoma (1/145),esophageal cyst (1/145) and esophageal varices (1/145).All patients expressed their willingness to receive the same type of upper GI endoscopy if necessary.No capsule retention,perforation or bleeding occurred.Conclusions MCE avoids the discomfort of conventional gastroscopy and can improve the compliance and acceptability of patients with excellent safety,maneuverability and feasibility.

Lymphoma is a malignant neoplasm classically involving the lymph and reticuloendothelial tissues. According to the World Health Organization classification (2000) for non-Hodgkin's lymphoma (NHL), there are over 20 different subtypes, each with its own characteristics and behavior. Gastrointestinal lymphoma is a less common type of NHL, usually affecting the stomach, colon and small intestines. The esophagus, however, is rarely involved. Here the investigators report a case of primary NHL of the esophagus so that this may be of help to physicians in future encounters.