Prospective feasibility study on the use of multiband mucosectomy for endoscopic resection of early squamous neoplasia in the esophagus

BACKGROUND AND STUDY AIMS

Endoscopic resection for esophageal squamous high-grade intraepithelial neoplasia (HGIN) or intramucosal cancer (esophageal squamous cell carcinoma [ESCC]) with the endoscopic resection cap technique is technically difficult, and requires submucosal lifting and multiple snares for piecemeal resections. Multiband mucosectomy (MBM) is an easy-to-use endoscopic resection technique and may be the modality of choice in China, where ESCC is extremely prevalent. The aim of the current study was to prospectively evaluate MBM for piecemeal endoscopic resection of squamous neoplasia of the esophagus.

METHODS

Patients with HGIN/ESCC and no signs of submucosal invasion or metastatic disease were included in the study. Lesions were delineated using electrocoagulation and resected using the MBM technique. Endpoints were procedure time, endoscopic radicality, complications, histology of the endoscopic resection specimens, and absence of HGIN/ESCC at the endoscopic resection scar during follow-up.

RESULTS

A total of 41 patients (26 male; mean age 61 years) underwent MBM; all lesions were visible with white light endoscopy (median length 5 cm, interquartile range [IQR] 4 - 6 cm; median circumferential extent 42 %, IQR 25 - 50 %). Median procedure time was 12 minutes (IQR 8 - 24 minutes). Median number of resections was 5 (IQR 3 - 6). Endoscopic complete resection was achieved in all lesions. There was one perforation, which was treated by application of clips. No other complications were observed. The worst histology was ESCC (n = 19), HGIN (n = 17), middle grade intraepithelial neoplasia (n = 4), and normal squamous epithelium (n = 1). Endoscopic follow-up at 3 months showed HGIN at the endoscopic resection scar in two patients, which was effectively treated endoscopically, and showed normal squamous epithelium in all patients at final follow-up (median 15 months, IQR 12 - 24 months).

CONCLUSION

This first prospective study on MBM for piecemeal endoscopic resection of early esophageal squamous neoplasia showed that MBM was effective for the complete removal of lesions with short procedure time, few complications, effective histological assessment of resected specimens, and durable treatment effect.

A comparative study of two kinds of small bowel cleaning score system for capsule endoscopy

AIM

The study is aim to compare two kinds of cleaning score system for capsule endoscopy, with a view of these two cleaning score system can help to evaluate small bowel cleanliness.

METHODS

Three readers evaluated these two cleaning score system by assessing the inter-observer, intra-patient, and intraobserver agreement.

RESULTS

The assessment of the reliability and concordance, inter-observer agreement and intra-patient agreement of System1 and System2 was excellent with the intraclass correlation coefficient (ICC) values of 0.873, 0.821, 0.863 and 0.772. The data regarding the assessment on intra-observer agreement and intrapatient agreement of System1 and System2 were available and the results were also excellent with ICC values of 0.887, 0.846, 0.870 and 0.809. The overall adequacy assessment of System1 and System2, there was no significant difference among the three readers of inter-observer agreement (X2 = 0.051, P = 0.822, X2 = 0.085, P = 0.081, X2 = 0.048, P = 0.827) and intra- patient agreement (X2 = 0.196, P = 0.658, X2 = 0.208, P = 0.648, X2 = 0.054, P = 0.817), neither was intra-observer agreement (X2 = 0.208, P = 0.648, X2 = 0.223, P = 0.637, X2 = 0.484, P = 0.487) and intrapatient agreement (X2 = 0.054, P = 0.817, X2 = 0.054, P = 0.817, X2 = 0519, P = 0.471).

CONCLUSION

The two system both are simple, operable, and can be used in clinical practice.

The onion skin-like organization of the septum arises from multiple embryonic origins to form multiple adult neuronal fates

In the past several decades, tremendous progress has been achieved through developmental studies of the central nervous system structures such as the cerebral cortex. The septum, which receives reciprocal connections from a variety of brain structures, contains diverse projection neurons but few interneurons. However, the mechanisms underlying its development remain poorly understood. Here we show that the septum is organized into an onion skin-like structure composed of five groups of neurons. These neurons are parvalbumin, choline acetyltransferase, neuronal nitric oxide synthase, calretinin and calbindin immunoreactive. Using the BrdU birth-dating method, we found that these five groups of neurons in the septum are grossly generated following an outside-in pattern. Interestingly, the distinct molecular identities of these neuronal subtypes correspond to their heterogeneous subpallial origins. Using three specific transgenic mouse lines and focal in utero electroporation of Cre-reporter plasmid, we showed that septal neurons originate from not only local progenitor regions but also neighboring progenitor regions including the medial ganglionic eminence and preoptic area. Thus, the neuronal diversity of the septum is achieved through both temporal and spatial control. Our results also suggest that multiple neuronal subtypes arrive to the septum through both radial and tangential migration. Based on these findings, we proposed a novel developmental model involving multiple spatial-temporal origins of septal neurons. This study presents new perspectives for comprehensively exploring septal functions in brain circuits.

'Green'-synthesized near-infrared PbS quantum dots with silica-PEG dual-layer coating: ultrastable and biocompatible optical probes for in vivo animal imaging

In this paper, PbS semiconductor quantum dots (QDs) with near-infrared (NIR) photoluminescence were synthesized in oleic acid and paraffin liquid mixture by using an easily handled and 'green' approach. Surface functionalization of the QDs was accomplished with a silica and polyethylene glycol (PEG) phospholipid dual-layer coating and the excellent chemical stability of the nanoparticles is demonstrated. We then successfully applied the ultrastable PbS QDs to in vivo sentinel lymph node (SLN) mapping of mice. Histological analyses were also carried out to ensure that the intravenously injected nanoparticles did not produce any toxicity to the organism of mice. These experimental results suggested that our ultrastable NIR PbS QDs can serve as biocompatible and efficient probes for in vivo optical bioimaging and has great potentials for disease diagnosis and clinical therapies in the future.

Facile and efficient route to polyimide-TiO2 nanocomposite coating onto carbon fiber

Polyamic acid-TiO(2) hybrid colloid emulsion with an average particle size of 200 nm was formed by dispersing nano-TiO(2) into polyamic acid colloidal emulsion. The polyimide-TiO(2) nanocomposite was coated onto carbon fiber by electrophoretic deposition. The primary properties of polyamic acid-TiO(2) hybrid colloid emulsion and polyimide-TiO(2) nanocomposite coating onto carbon fiber were characterized using laser scattering, ZetaPlus particle sizing, transmission electron microscopy, field-emission scanning electron microscope, Fourier transforms infrared spectroscopy, and X-ray Diffraction analysis. The results indicated that the small amount of nano-TiO(2) would be effectively dispersed in polyamic acid colloidal particles. The polyimide-TiO(2) hybrid nanocomposite coating carbon fiber sheet displayed an excellent photodegradation performance of methyl orange, which could be degraded more than 70 wt % after 10 cycles.

A novel allergen Tab y 1 with inhibitory activity of platelet aggregation from salivary glands of horseflies

BACKGROUND

Horsefly sting causes allergic reactions in human body. However, our knowledge on horsefly allergens remains poor.

OBJECTIVES

To identify the novel horsefly allergens and characterize their properties.

METHODS

A native allergen protein Tab y 1 (apyrase) was purified from the salivary glands of the horsefly Tabanus yao Macquart by gel filtration and ion exchange chromatography. Its sequence was determined by Edman degradation and cDNA cloning. Its allergenicity was assessed by immunoblotting for specific IgE, basophil activation test, skin prick test (SPT), and competitive enzyme-linked immunosorbent assay (ELISA).

RESULTS

Tab y 1 showed a single diffusion band of 70 kDa on SDS-PAGE. Seventy percent (7/10) of patients with horsefly allergy tested positive to Tab y 1 in SPT; sera from 81% (30/37) of patients reacted to Tab y 1 on western blots. Purified Tab y 1 reduced approximately 42% sera IgE reactivity to horsefly salivary gland extract on a competitive ELISA. Tab y 1 upregulated the expression of CD63 and CCR3 on passively sensitized basophils by up to approximately 4.9-fold. Tab y 1 also showed enzymatic activity to hydrolyze ATP and ADP, and potent antiplatelet aggregation and antithrombotic activities.

CONCLUSION

The current work identified a novel major allergen of horsefly, Tab y 1, with antiplatelet aggregation and antithrombotic activities, which implicates Tab y 1 in helping horseflies suck host blood, meanwhile causing allergy in their human hosts.

Cloning, molecular characterization and heterologous expression of a glutathione S-transferase gene in rice

OsGSTL2 is one of three tandem-arranged glutathione S-transferase, lambda class genes in chromosome 3 of rice (Oryza sativa L.). It includes 9 introns and 10 exons, and encodes a protein of 244 amino acid residues with a calculated molecular mass of 27.37 kDa. The predicted three-dimensional structure of OsGSTL2 showed a typical glutathione S-transferase fold. Using semi-quantitative RT-PCR analysis, OsGSTL2 transcript was detected in the roots and leaves of seedling stage and tillering stage, and the roots, leaves and panicles of heading stage from rice plants, and the expression level of OsGSTL2 mRNA in rice roots show significant change under chlorsulfuron stress. The OsGSTL2 gene was cloned into pYTV vector and was transformed into yeast strain PEP4. Western blot analysis showed the exogenous OsGSTL2 was expressed in transformed yeast. GST activity of crude extracts of yeast showed the OsGSTL2 transgenic yeast had higher levels of GST activities than control yeasts. These findings suggested that the OsGSTL2 is a glutathione S-transferase and has potential use in detoxification.