Objective:To compare the role of double-balloon enteroscopy (DBE) and dual-energy CT enterography (DCTE) in evaluating the clinical characteristics of Crohn′s disease (CD).Methods:From July 1, 2016 to November 1, 2023, 72 patients with CD who underwent both DBE and DCTE (with an interval of less than 3 months) in the First Affiliated Hospital of Soochow University were enrolled in this retropective study. Among them, 4 patients underwent both DBE and DCTE twice (a total of 76 cases). The data of DBE and DCTE in the diagnosis of 76 CD cases were analyzed, including the diagnostic rate of CD, the consistency of the 2 methods in detecting the lesion location (ileocecal, colonic, ileocolonic, and upper gastrointestinal tract involvement), and the detection rates of stenosis, ulcer and the location, long ulcer (long-diameter≥2 cm), and fistula. Kappa test was performed for the consistency analysis, and Chi-square test was used for statistical analysis.Results:The diagnostic rate of CD by DBE was higher than that by DCTE (80.3% (61/76) vs. 65.8% (50/76)), and the diagnostic rate of combination of the 2 methods (89.5% (68/76)) was higher than that by DCTE alone, and the differences were statistically significant ( χ2=4.04 and 12.28, P=0.044 and <0.001). The result of Kappa consistency test showed that the consistency of CD lesion location detected by DBE and DCTE was poor (Kappa value=0.29, t=3.17, P=0.002). The detection rate of stenosis by DBE was higher than that by DCTE (46.1% (35/76) vs. 13.2% (10/76)), the detection rate of stenosis by combination of the 2 methods (52.6% (40/76)) was higher than that by DCTE alone, and the differences were statistically significant ( χ2=19.73 and 26.82, both P<0.001). There were no statistically significant differences in the detection rates of fistula among DBE, DCTE, and the combination of the 2 methods (3.9%(3/76), 2.6% (2/76), 5.3% (4/76); all P>0.05). The detection rate of ulcer by DBE was higher than that by DCTE(73.7% (56/76) vs. 7.9% (6/76)), the detection rate of ulcer by combination of the 2 methods (76.3%(58/56)) was higher than that by DCTE alone, and the differences were statistically significant ( χ2=68.10 and 72.98, both P<0.001). The detection rates of long ulcer and non-terminal ileum ulcer by DBE were both 17.9% (10/56). All the 6 cases with ulcer detected by DCTE were located in the terminal ileum, and no long ulcers were observed. Conclusions:In the diagnosis of CD, as well as in the detection of stenosis and ulcer, DBE and the combination of DBE and DCTE have more advantages over DCTE alone. The consistency between DBE and DCTE in identifying the location of lesion is poor. DBE has advantages in detecting long ulcer and non-terminal ileum ulcer.

Objective:To evaluate the efficacy of eradication therapy based on potassium-competitive acid blocker (P-CAB) for Helicobacter pylori( HP) infection in re-eradication therapy (the second-line therapy treatment after initial eradication failure of HP infection) and determine whether it can achieve the ideal eradication rate (90%). Methods:From January 2022 to December 2023, the clinical data of patients who received vonoprazan-based HP re-eradication therapy were collected in Department of Gastroenterology, the First Affiliated Hospital of Soochow University. The patients were divided into 4 groups according to their different HP treatment regimens, including VAMB group (vonoprazan 20 mg, quaque die( qd)+ amoxicillin 1 g, bis in die( bid)+ minocycline 100 mg, bid+ potassium bismuth citrate 220 mg, bid; 156 cases), VA group (vonoprazan 20 mg, bid+ amoxicillin 1 g, ter in die( tid); 44 cases), VMFB group (vonoprazan 20 mg qd+ minocycline 100 mg, bid+ furazolidone 100 mg, bid+ potassium bismuth citrate 220 mg, bid; 42 cases), and VAFB group (vonoprazan 20 mg, qd+ amoxicillin 1 g, bid+ furazolidone 100 mg, bid + potassium bismuth citrate 220 mg, bid; 13 cases). All the 4 groups of patients took the medication for 14 days. The 13C or 14C urea breath test would be conducted 4 weeks after the treatment. The overall eradication rate to evaluate the treatment efficacy. The eradication rate and adverse reaction rate were calculated for each group, and the eradication rates and adverse reaction rates between groups were compared using the chi-square test or Fisher′s exact test. Results:The total eradication rate of HP infection based on P-CAB therapy was 91.8% (234/255), and the total adverse reaction rate was 5.1% (13/255). The eradication rate and adverse reaction rate were 92.9% (145/156) and 3.2% (5/156) in the VAMB group, 84.1% (37/44) and 0 in the VA group 95.2% (40/42) and 11.9% (5/42) in the VMFB group, 12/13 and 3/13 in the VAFB group, respectively. Additionally, there was no statistical difference in the eradication rate among the 4 groups (Fisher′s exact test, P=0.227), but there was a statistical difference in the adverse reaction rates (Fisher′s exact test, P=0.002), and the adverse reaction rate of the VAFB group was higher than that of VAMB and VA groups and the differences were statistically significant (both Fisher′s excact test, P=0.016 and 0.010). Conclusions:The total HP re-eradication rate based on P-CAB therapies can reach 91.8%, achieving the ideal eradication rate of HP infection. The VA therapeutic regimen has the lowest incidence of adverse reactions, representing a novel therapeutic option for HP re-eradication.

Objective:To compare the role of double-balloon enteroscopy (DBE) and dual-energy CT enterography (DCTE) in evaluating the clinical characteristics of Crohn′s disease (CD).Methods:From July 1, 2016 to November 1, 2023, 72 patients with CD who underwent both DBE and DCTE (with an interval of less than 3 months) in the First Affiliated Hospital of Soochow University were enrolled in this retropective study. Among them, 4 patients underwent both DBE and DCTE twice (a total of 76 cases). The data of DBE and DCTE in the diagnosis of 76 CD cases were analyzed, including the diagnostic rate of CD, the consistency of the 2 methods in detecting the lesion location (ileocecal, colonic, ileocolonic, and upper gastrointestinal tract involvement), and the detection rates of stenosis, ulcer and the location, long ulcer (long-diameter≥2 cm), and fistula. Kappa test was performed for the consistency analysis, and Chi-square test was used for statistical analysis.Results:The diagnostic rate of CD by DBE was higher than that by DCTE (80.3% (61/76) vs. 65.8% (50/76)), and the diagnostic rate of combination of the 2 methods (89.5% (68/76)) was higher than that by DCTE alone, and the differences were statistically significant ( χ2=4.04 and 12.28, P=0.044 and <0.001). The result of Kappa consistency test showed that the consistency of CD lesion location detected by DBE and DCTE was poor (Kappa value=0.29, t=3.17, P=0.002). The detection rate of stenosis by DBE was higher than that by DCTE (46.1% (35/76) vs. 13.2% (10/76)), the detection rate of stenosis by combination of the 2 methods (52.6% (40/76)) was higher than that by DCTE alone, and the differences were statistically significant ( χ2=19.73 and 26.82, both P<0.001). There were no statistically significant differences in the detection rates of fistula among DBE, DCTE, and the combination of the 2 methods (3.9%(3/76), 2.6% (2/76), 5.3% (4/76); all P>0.05). The detection rate of ulcer by DBE was higher than that by DCTE(73.7% (56/76) vs. 7.9% (6/76)), the detection rate of ulcer by combination of the 2 methods (76.3%(58/56)) was higher than that by DCTE alone, and the differences were statistically significant ( χ2=68.10 and 72.98, both P<0.001). The detection rates of long ulcer and non-terminal ileum ulcer by DBE were both 17.9% (10/56). All the 6 cases with ulcer detected by DCTE were located in the terminal ileum, and no long ulcers were observed. Conclusions:In the diagnosis of CD, as well as in the detection of stenosis and ulcer, DBE and the combination of DBE and DCTE have more advantages over DCTE alone. The consistency between DBE and DCTE in identifying the location of lesion is poor. DBE has advantages in detecting long ulcer and non-terminal ileum ulcer.

Objective:To evaluate the efficacy of eradication therapy based on potassium-competitive acid blocker (P-CAB) for Helicobacter pylori( HP) infection in re-eradication therapy (the second-line therapy treatment after initial eradication failure of HP infection) and determine whether it can achieve the ideal eradication rate (90%). Methods:From January 2022 to December 2023, the clinical data of patients who received vonoprazan-based HP re-eradication therapy were collected in Department of Gastroenterology, the First Affiliated Hospital of Soochow University. The patients were divided into 4 groups according to their different HP treatment regimens, including VAMB group (vonoprazan 20 mg, quaque die( qd)+ amoxicillin 1 g, bis in die( bid)+ minocycline 100 mg, bid+ potassium bismuth citrate 220 mg, bid; 156 cases), VA group (vonoprazan 20 mg, bid+ amoxicillin 1 g, ter in die( tid); 44 cases), VMFB group (vonoprazan 20 mg qd+ minocycline 100 mg, bid+ furazolidone 100 mg, bid+ potassium bismuth citrate 220 mg, bid; 42 cases), and VAFB group (vonoprazan 20 mg, qd+ amoxicillin 1 g, bid+ furazolidone 100 mg, bid + potassium bismuth citrate 220 mg, bid; 13 cases). All the 4 groups of patients took the medication for 14 days. The 13C or 14C urea breath test would be conducted 4 weeks after the treatment. The overall eradication rate to evaluate the treatment efficacy. The eradication rate and adverse reaction rate were calculated for each group, and the eradication rates and adverse reaction rates between groups were compared using the chi-square test or Fisher′s exact test. Results:The total eradication rate of HP infection based on P-CAB therapy was 91.8% (234/255), and the total adverse reaction rate was 5.1% (13/255). The eradication rate and adverse reaction rate were 92.9% (145/156) and 3.2% (5/156) in the VAMB group, 84.1% (37/44) and 0 in the VA group 95.2% (40/42) and 11.9% (5/42) in the VMFB group, 12/13 and 3/13 in the VAFB group, respectively. Additionally, there was no statistical difference in the eradication rate among the 4 groups (Fisher′s exact test, P=0.227), but there was a statistical difference in the adverse reaction rates (Fisher′s exact test, P=0.002), and the adverse reaction rate of the VAFB group was higher than that of VAMB and VA groups and the differences were statistically significant (both Fisher′s excact test, P=0.016 and 0.010). Conclusions:The total HP re-eradication rate based on P-CAB therapies can reach 91.8%, achieving the ideal eradication rate of HP infection. The VA therapeutic regimen has the lowest incidence of adverse reactions, representing a novel therapeutic option for HP re-eradication.

Mevalonate metabolism plays an important role in regulating tumor growth and progression; however, its role in immune evasion and immune checkpoint modulation remains unclear. Here, we found that non-small cell lung cancer (NSCLC) patients with higher plasma mevalonate response better to anti-PD-(L)1 therapy, as indicated by prolonged progression-free survival and overall survival. Plasma mevalonate levels were positively correlated with programmed death ligand-1 (PD-L1) expression in tumor tissues. In NSCLC cell lines and patient-derived cells, supplementation of mevalonate significantly up-regulated the expression of PD-L1, whereas deprivation of mevalonate reduced PD-L1 expression. Mevalonate increased CD274 mRNA level but did not affect CD274 transcription. Further, we confirmed that mevalonate improved CD274 mRNA stability. Mevalonate promoted the affinity of the AU-rich element-binding protein HuR to the 3'-UTR regions of CD274 mRNA and thereby stabilized CD274 mRNA. By in vivo study, we further confirmed that mevalonate addition enhanced the anti-tumor effect of anti-PD-L1, increased the infiltration of CD8⁺ T cells, and improved cytotoxic function of T cells. Collectively, our findings discovered plasma mevalonate levels positively correlated with the therapeutic efficacy of anti-PD-(L)1 antibody, and provided the evidence that mevalonate supplementation could be an immunosensitizer in NSCLC.

[This corrects the article DOI: 10.1016/j.apsb.2023.04.002.].

Objective:To investigate the effect of hyperbaric oxygen（HBO）on enhancing the drug sensitivity of esophageal cancer cell line ECA109 to paclitaxel（Pac）and its mechanism of action.Methods:After the in vitro culture of esophageal cancer ECA109 cells was completed，the cells were divided into four groups according to the experimental design：the control group，the Pac group，the HBO group，and the HBO + Pac group. The control group received Dimethyl sulfoxide；the Pac group received 5 mg/L of Pac（referring to the IC 50 value）；the HBO group was exposed to HBO alone for 90 minutes；the HBO + Pac group was exposed to HBO for 90 minutes first and then treated with 5 mg/L of Pac. The proliferation ability of ECA109 cells was detected by the CCK-8 method，the apoptosis of ECA109 cells was detected by flow cytometry，and the expressions of apoptotic proteins，drug resistance-associated proteins，and mitogen-activated protein kinase（MAPK）signaling pathway-associated proteins in ECA109 cells were detected by Western blotting. Results:Compared with the control group and the HBO group，the survival rate of ECA109 cells in the Pac group was significantly decreased，and the apoptosis rate was significantly increased（ P<0.05）. Compared with the Pac group，the survival rate of ECA109 cells in the HBO + Pac group was significantly decreased，and the apoptosis rate was significantly increased（ P<0.05）. Compared with the control group and the HBO group，the expressions of proteins（Bcl-2，caspase-9，and ERK）in ECA109 cells of the Pac group and the HBO + Pac group were significantly decreased（ P<0.05），and the expressions of proteins（Bad，caspase-3，PARP，p-JNK，and p38）were significantly increased（ P<0.05）. Compared with the Pac group，the expressions of proteins（Bad and caspase-3）in ECA109 cells of the HBO + Pac group were significantly increased，and the expression of protein P-gp was significantly decreased（ P<0.05），while the expressions of proteins（Bcl-2，caspase-9，and PARP）were not significantly changed（ P>0.05）. Conclusion:HBO combined with Pac treatment can enhance the proliferation inhibitory and apoptosis-inducing effects of Pac on ECA109 cells，and its mechanism of action may be achieved by regulating the MAPK signaling pathway in ECA109 cells.

Objective:To investigate the effect of hyperbaric oxygen（HBO）on enhancing the drug sensitivity of esophageal cancer cell line ECA109 to paclitaxel（Pac）and its mechanism of action.Methods:After the in vitro culture of esophageal cancer ECA109 cells was completed，the cells were divided into four groups according to the experimental design：the control group，the Pac group，the HBO group，and the HBO + Pac group. The control group received Dimethyl sulfoxide；the Pac group received 5 mg/L of Pac（referring to the IC 50 value）；the HBO group was exposed to HBO alone for 90 minutes；the HBO + Pac group was exposed to HBO for 90 minutes first and then treated with 5 mg/L of Pac. The proliferation ability of ECA109 cells was detected by the CCK-8 method，the apoptosis of ECA109 cells was detected by flow cytometry，and the expressions of apoptotic proteins，drug resistance-associated proteins，and mitogen-activated protein kinase（MAPK）signaling pathway-associated proteins in ECA109 cells were detected by Western blotting. Results:Compared with the control group and the HBO group，the survival rate of ECA109 cells in the Pac group was significantly decreased，and the apoptosis rate was significantly increased（ P<0.05）. Compared with the Pac group，the survival rate of ECA109 cells in the HBO + Pac group was significantly decreased，and the apoptosis rate was significantly increased（ P<0.05）. Compared with the control group and the HBO group，the expressions of proteins（Bcl-2，caspase-9，and ERK）in ECA109 cells of the Pac group and the HBO + Pac group were significantly decreased（ P<0.05），and the expressions of proteins（Bad，caspase-3，PARP，p-JNK，and p38）were significantly increased（ P<0.05）. Compared with the Pac group，the expressions of proteins（Bad and caspase-3）in ECA109 cells of the HBO + Pac group were significantly increased，and the expression of protein P-gp was significantly decreased（ P<0.05），while the expressions of proteins（Bcl-2，caspase-9，and PARP）were not significantly changed（ P>0.05）. Conclusion:HBO combined with Pac treatment can enhance the proliferation inhibitory and apoptosis-inducing effects of Pac on ECA109 cells，and its mechanism of action may be achieved by regulating the MAPK signaling pathway in ECA109 cells.

BACKGROUND:LARS artificial ligament was designed by Laboureau from France using polyethylene terephthalates with the anatomic structure of human ligament and mechanical principle of weight.This ligament is not only accorded with physiological structure of normal anterior cruciate ligament,but also significantly elevates anti-torque,can resist repetitive twist,bend and excessive traction.OBJECTIVE:To summarize characteristics of clinical application of LARS artificial ligament in transplant reconstruction following acute anterior cruciate ligament of knee joint injury.METHODS:A total of 23 patients with acute anterior cruciate ligament injury,comprising 17 males and 6 females,aged 21-54 years,were selected.Time-from injury to surgery was 3 days to 3 weeks.Polyethylene terephthalatas LARS artificial ligament made in France was used to reconstruct damaged ligament.The transplant was evaluated before and after implantation according to Lysholm knee joint criteria.RESULTS AND CONCLUSION:Following 11.2 months (10-14 months) of follow-up,unstable symptoms of affected knees of all 23 cases disappeared.Anterior and posterior drawer tests were negative,with good joint function.Average extension and flexion degree was 0°-120°.In accordance with Lysholm knee joint score,significant difference was found from (40.34±4.00) points preoperatively to (90.21±4.00) points postoperatively (P<0.01).They could do common athletic activities at about 2 months following surgery.In some cases,magnetic resonance examination demonstrated that residue ligament gradually grew into artificial ligament,which gradually became thicker.Above-mentioned results have verified that under an arthroscope,reconstruction of anterior cruciate ligament using polyethylene terephthalates LARS artificial ligament showed simple operation and small wound,which may lead to immediate stability,early rehabilitation exercises.Simultaneously,interlacing of residue ligament and artificial ligament keeps the nerve conduction pathway of propdoceptive sense,which prevents joint function limitation greatly.Moreover,short-term outcomes are satisfactory.