Objective To study the function of γδT lymphocytes in patients with lung cancer.Methods γδT lymphocytes in peripheral blood of the 124 preoperative patients with lung cancer(experiment group) and 56 healthy donors(control group) were detected by Flow Cytometry. Results The percentage of γδT cells(CD+3 γδTCR+) was (6.54±2.90) % in control group and (3.76±2.81) % in experiment group (t =3.568,P ＜0.001). The γδT cells in peripheral blood of patients with lung cancer was less than that of healthy donors (t =3.568, P ＜0.001). There was significant difference in expression of γδT cells in the peripheral blood between the all test groups and healthy control group (P =0.000). Compared with control group, γδT cells of the peripheral blood in experiment group were correlated with TNM stage, general types, pathological changes position and histology grades (P ＜0.05). The expression of γδT cells in the peripheral blood were not associated with age, gender (P ＞0.05). Conclusion The results suggested that the dysfunction of γδT had important function on the development of lung cancer.

Objective To assess the association between glutathione S-transferase T1 (GSTT1 )gene and the susceptibility of colorectal cancer among Chinese population.Methods Clinical controlled trials of the association between GSTT1 and the susceptibility of colorectal cancer among Chinese population were searched in PubMed,EMBase,Cochrane Library,China Biology Medicine disc,VIP database,China National Knowledge Infrastructure and Wanfang database.According to the inclusion and exclusion criteria,data extraction and quali-ty assessment were done by two researchers independently.Outcomes were pooled with RevMan 5.1 .Results 326 studies were found and 10 clinical controlled trails including 2 983 cases of colorectal cancer and 4 386 cases of healthy objects were included in this analysis.The results of Meta-analysis showed that the lack of GSTT1 gene is associated with colorectal cancer susceptibility (RR =1 .11 ,95%CI:1 .06-1 .17,Z =4.26,P <0.000 1 ). Conclusion The loss of GSTT1 increase the risk of colorectal cancer among Chinese population.

Objective To evaluate the clinical value of endoscopic piecemeal mucosal resection (EPMR) and endoscopic submucosal dissection (ESD) for treatment of esophageal mucosal lesion with diameter larger than 15 mm.Methods The data of 261 patients with esophageal mucosal lesions ≥15 mm and undergoing ESD (n=198) or EPMR (n=63) in Endoscopy Center of Zhongshan Hospital from September 2009 to August 2011 were retrospectively analyzed.Therapeutic effect, complications, and local recurrence were compared between the two groups.Results The lesion size was significantly larger in the ESD group than that in the EPMR group (3.02±1.13 mm VS 2.66±0.95 mm, P<0.05).The rates of en bloc resection, complete resection, and curative resection were 100% (198/198), 96% (190/198), and 94% (187/198), respectively in the ESD group.Only samples with horizontal margin obtained the pathological assessment in the EPMR group, and 2 cases were positive.The incidence of short-term complications including massive bleeding and perforation was no statistically different (P>0.05) between the two groups.The rate of postoperative esophageal stricture was higher in the EPMR group than that of the ESD group [22.6% (14/62) VS 6.2% (12/194),P<0.05] except for 5 cases with further surgery treatment (4 cases in the ESD group and 1 case in the EPMR group).The local recurrence rate was also higher in the EPMR group than that of the ESD group [11.5% (7/61) VS 3.7% (7/190), P<0.05], except for 10 cases with positive margin.Conclusion The therapeutic effect of ESD is superior to that of EPMR for esophageal mucosal lesions with diameter larger than 15 mm due to lower rate of local recurrence and acceptable complications.

ObjectiveTo study the diagnostic and therapeutic value of endoscopy for gastrointestinal (GI) schwannoma.MethodsWe retrospectively studied data of 13 patients who underwent endoscopy and were confirmed as having GI schwannoma by pathology in our hospital during January 2006 and July 2011.ResultsSchwannoma of 8 patiets located in stomach,3 in esophagus and 2 in colon.Endoscopic ultrasonography showed schwannoma originated from muscularis propria,characterized by hypoecho.Twelve patients received endoscopic treatment,and 11 were successfully removed.The en bloc resection rate was 91.7％.Among them,6 were treated by endoscopic submucosal excavation,4 by endoscopic full-thickness resection and one by submucosal tunnel endoscopic resection.Another patient with schwannoma located in esophagus with a maximum diameter of 4.7 cm was transferred to thoracic surgery since the tumor had a wide base even after partial resection.No bleeding,inflammation or abscess occurred.The average follow-up time was 23.3 ± 10.8 months ( range,6-36 months).No metastasis or recurrence was found during follow-up.ConclusionEndoscopy and endoscopic ultrasonography,safe and efficacious,are valuable for the diagnosis and treatment of GI schwannoma.

OBJECTIVETo evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for the treatment of gastrointestinal cysts.

METHODSClinicopathological data of 40 patients with gastrointestinal cyst undergoing ESD in our center during January 2008 and February 2012 were analyzed retrospectively. Complications, en bloc resection rate, and local recurrence were assessed.

RESULTSEight lesions located in the esophagus, 11 in the stomach, 5 in the duodenum, and 16 in the colorectum. Thirty-seven lesions were successfully resected with ESD in an en bloc fashion (92.5%). During the operation, one perforation was encountered in the ascending colon and was clipped; one massive hemorrhage occurred in the esophagus and was treated with balloon compression. Postoperative pathological examination revealed cyst samples were intact without lesions in lateral and basal resection margins. Local recurrence was not found in 36 patients during a median postoperative follow-up of 9.7 months (range, 6-12 months).

CONCLUSIONESD is a safe and effective procedure for the treatment of gastrointestinal cysts.

Adult ; Aged ; Cysts ; surgery ; Digestive System Neoplasms ; surgery ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Mucous Membrane ; surgery ; Retrospective Studies

Objective To evaluate the safety and efficacy of endoscopic submucosal dissection (ESD) for superficial hypopharyngeal neoplasm. Methods Clinicopathological data of 9 patients, who received ESD for superficial hypopharyngeal neoplasm in Zhongshan Hospital affiliated to Fudan University from September 2015 to March 2018,were retrospectively analyzed. Results Nine patients including 7 males and 2 females with mean age of 61. 2 years (48-80 years) were included. The mean diameter of lesions was 16. 3 mm (5-27 mm),and the mean operation time was 52. 2 min(30-90 min). No bleeding, perforation, emphysema or dyspnea during or after ESD occurred. The mean length of hospitalization was 4. 6 days ( 3-7 days). Pathology indicated 1 high grade intraepithelial neoplasia and 8 squamous cell cancer, and all cases of squamous cell cancer were constrained within lamina propria. One patient had positive horizontal margin and received radiotherapy. No recurrence, metastasis or stenosis was found during 10. 2 months (3-29 months)of follow-up. Conclusion ESD is a safe and effective option for superficial hypopharyngeal neoplasm.

Background/Aims: Previous studies reveal that immune-mediated neuroinflammation plays a key role in the etiology of esophageal achalasia. However, the understanding of leucocyte phenotype and proportion is limited. This study aim to evaluate the phenotypes of leukocytes and peripheral blood mononuclear cells transcriptomes in esophageal achalasia. Methods: We performed high-dimensional flow cytometry to identified subsets of peripheral leukocytes, and further validated in lower esophageal sphincter histologically. RNA sequencing was applied to investigate the transcriptional changes in peripheral blood mononuclear cells of patients with achalasia. Cell-type Identification by Estimating Relative Subsets of RNA Transcripts (CIBERSORT) was used for estimating the immune cell types. A differential gene expression analysis was performed and the differential expressed genes were subjected to gene ontology, Kyoto Encyclopedia of Genes and Genomes network, protein-protein interaction network construction. Results: An imbalance between innate and adaptive immune cells occurred in achalasia. Specifically, neutrophils and CD8+ T cells increased both in peripheral blood and lower esophageal sphincter in achalasia. Eosinophils decreased in peripheral blood but massively infiltrated in lower esophageal sphincter. CIBERSORT analysis of peripheral blood mononuclear cells RNA sequencing displayed an increased prevalence of CD8+ T cells. 170 dysregulated genes were identified in achalasia, which were enriched in immune cells migration, immune response, etc. Proton pump inhibitor analysis revealed the intersections and gained 7 hub genes in achalasia, which were IL-6, Toll-like receptor 2, IL-1β, tumor necrosis factor, complement C3, and complement C1q A chain. Conclusion Patients with achalasia exhibited an imbalance of systematic innate and adaptive immunity, which may play an important role in the development of achalasia.

BACKGROUNDTo study the clinical effects of ¹⁵³Sm-EDTMP plus chemotherapy in the treatment of bone metastasis of lung cancer.

METHODSOne hundred and ten lung cancer patients with one metastasis [male 82 and female 28, aged from 32 to 76 yrs; squamous cell carcinoma 28, adenocarcinoma 27, small cell lung cancer (SCLC) 7, mix type 41, alveolar carcinoma 7] who did not undergo an operation were entered into this study. The patients were divided into 3 groups: ¹⁵³Sm-EDTMP therapy only (37 cases), ¹⁵³Sm-EDTMP plus chemotherapy after 3 days (42 cases), 30 days after chemotherapy plus ¹⁵³Sm-EDTMP (31 cases). The dosages of ¹⁵³Sm-EDTMP ranged from 1 111 to 2 660 MBq. The patients with SCLC were adapted CCNU, MTX and CTX; those with non-small cell lung cancer (NSCLC) were adapted MMC, VCR and DDP. Statistic analysis of the data was performed by Chi-square test.

RESULTSTotal pain relief rate for ¹⁵³Sm-EDTMP only was 89.2% , for ¹⁵³Sm-EDTMP plus chemotherapy was 92.8%, and for chemotherapy plus 153 Sm EDTMP was 90.3% . The foci disappeared in 9 cases with ¹⁵³Sm-EDTMP only, in 12 cases with ¹⁵³Sm-EDTMP plus chemotherapy, and in 9 cases with chemotherapy plus ¹⁵³Sm-EDTMP. The 1 year survival rate was 29.7%(11/37) by 153 Sm only, 40.5%(17/42) by 153 Sm plus chemotherapy, 38.7%(12/31) by chemotherapy plus ¹⁵³Sm-EDTMP.

CONCLUSIONS¹⁵³Sm-EDTMP plus chemotherapy is effective in the treatment of bone metastasis of lung cancer.

Objective:To summarize the thoracic and abdominal CT presentations after endoscopic full-thickness resection (EFR) and to analyze its significance in the evaluation and management of postoperative complications.Methods:Data of 82 patients who underwent gastrointestinal EFR at the Endoscopy Center of Zhongshan Hospital, Fudan University and received a chest and/or abdominal CT within 1 week from September 2016 to September 2021 were collected retrospectively. The patients were divided into the intervention group ( n=38) and the control group ( n=44) according to the presence or absence of special postoperative interventions or prolonged hospital stays. The differences in the incidence of abnormal CT presentations between the two groups were analyzed. Risk factors for abnormal CT presentation were explored by multifactorial analysis. Results:Among the 82 patients, the main CT presentations were pneumoperitoneum in 51 patients (62.2%), abdominal and pelvic effusion in 30 patients (36.6%), pneumothorax in 5 (6.1%), pleural effusion in 43 (52.4%), and pulmonary inflammation in 16 (19.5%). The incidence of pelvic and abdominal effusions ( W=637.48, P=0.031) and pleural effusions ( W=622.06, P=0.031) in CT was higher in the intervention group than that in the control group. Age was an independent risk factor for air-related complications after EFR (>60 years old VS ≤60 years old: OR=0.17, 95% CI: 0.05-0.56, P=0.002). Conclusion:CT presentations of pelvic and abdominal effusion and pleural effusion after EFR is of great significance in suggesting complications, while patients with other CT presentations often do not require special intervention or prolonged hospital stay. Postoperative CT in elderly patients is less likely to detect air-related complications.

Metabolic reprogramming is one of the significant characteristics of malignant tumor development. It provides the tumor with sufficient energy and materials. During the process by which tumor cells acquire metabolic reprogramming, epigenetic changes play a crucial role. N6-methyladenosine (m6A) in mRNA is the most common post-transcriptional modification of mRNA. It regulates the transcription, maturation, translation, and degradation of mRNA. Studies have shown that m6A helps promote the metabolic reprogramming of tumor cells. However, the complete mechanism still requires further research. METTL3 is a key enzyme for m6A methylation that catalyzes m6A progression by forming complexes with other proteins, such as METTL14 and WTAP. Notably, the critical role of METTL3 in the metabolic transition of gastrointestinal tumors has not been given due attention. This article summarizes the specific pathways through which METTL3 affects the reprogramming of cellular glucose metabolism in gastrointestinal tumors. We aimed to clarify the importance of METTL3 in the energy reprogramming of gastrointestinal tumors.