The diagnosis and treatment of papillary cystadenoma of the esophagus by the Endoscopy : a case report and literature review

Papillary cystadenoma is a epithelial benign tumor of the salivary gland, most commonly in the oral cavity, head and neck. There was no difference in the sex distribution of patients, and the age of onset was 30-50 years old. The clinical manifestations are: slow growth local mass, long course of disease, some can be as long as decades, most patients have no obvious conscious symptoms, a few patients can appear local pain or distension. However, papillary cystadenoma of the esophagus is very rare, and few cases have been reported. We report a case of papillary cystadenoma of the lower esophagus and its treatment by endoscopy. The patient had no obvious complaint of discomfort. Routine gastroscopy found submucosal protuberant lesions in the lower segment of the esophagus (Figure 1), and endoscopic ultrasonography suggested cystic and solid lesions originating from the muscular layer of the esophageal mucosa, thus mesenchymal tumor was preliminarily diagnosed (Figure 2). After the exclusion of relevant contraindications, preoperative examinations were completed and the tumor was completely removed by esophageal submucosal tumor excision under endoscopy (Figure 3). Postoperative pathology indicated the tumor is papillary cystadenoma, and immunohistochemistry indicated that: CK7(+), CK(+), and basal cells of P63 (+) (Figure 4, 5). Due to the rare case, combined with the process of the diagnosis and treatment of this case, we reviewed the relevant reports on the papillary cystadenoma of the digestive tract in the past 60 years, in order to help clinicians to improve their understanding and treatments of the papillary cystadenoma.</jats:p

The Effect of Nasopharyngeal Ventilation on the Detection Rate of Colorectal Polyps in Two Hundred Middle-Aged and Elderly Overweight Patients

Objective To analyze the effect of nasopharyngeal ventilation on the detection rate of colorectal polyps in 200 middle-aged and elderly overweight patients during painless colonoscopy. Methods A total of 100 patients aged 50-75 years, body mass index (BMI) ≥24 or abdominal circumference ≥85 cm in males and ≥82 cm in females, without underlying diseases, who underwent nasopharyngeal ventilation during painless colonoscopy at physical examinations in our hospital from 2019 to 2020, were selected as the observation subjects (n = 100). The control sample area was determined by propensity matching according to the basic information characteristics presented by the observation group. 100 patients received mask oxygen at physical examinations were randomly selected in the control group (n = 100). Results The verification analysis after matching indicated that there were no intraoperative and postoperative adverse reactions, the number of intraoperative limb movements was less than 1, and the intestinal peristalsis intervals were more than 5s in both groups, without atropine intervention. Colonoscopy was performed by senior endoscopists with a withdrawal time of 6-8 min. When the intraoperative SpO2 was lower than 90% but higher than 85%, the patients in the observation group underwent nasopharyngeal ventilation while those in the control group received mask oxygen assisted chin-lift. As a result, the SpO2 was maintained higher than 90%. The detection rate of colorectal polyps was compared between the two groups. Conclusion The detection rate of colorectal polyps in the observation group was higher than that in the control group, with a statistically significant difference. It may result from the reduction of ineffective respiratory movement and intraoperative intestinal peristalsis in middle-aged and elderly overweight patients.</jats:p

Effect of Helicobacter pylori enrichment in adenoma on clinical and pathological features of colorectal adenoma

Abstract Objective To observe the enrichment of Helicobacter pylori in adenoma tissues of patients with colorectal adenoma and analyze its effect on the clinical and pathological features of colorectal adenoma. Methods The data of 1622 cases of gastrointestinal endoscopy in the Endoscopy Center of Zhejiang Chinese Medical University Affiliated Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2019 to June 2021 were retrospectively collected. The general data, gastric Hp infection, clinical and pathological features of colorectal adenoma, special staining of Hp methylblue in adenoma, and immunohistochemical staining of Hp in adenoma were compared between colorectal adenoma group (743 cases) and control group (879 cases). Results There were 361 cases (48.59%) of gastric Hp positive in colorectal adenoma group and 331 cases (37.66%) of gastric Hp positive in control group. The difference was significant (P &lt; 0.001). Found that gastric Hp infection significantly increased the risk of Hp enrichment in colorectal adenoma tissues (OR: 28.449; 95% CI: 18.188 – 44.500; P &lt; 0.001). Hp enrichment in colorectal adenomas was also found to be a contributing factor for positive events in terms of adenoma diameter, adenoma pathological type, and adenoma malignancy (OR: 3.536; 3.652; 2.833; P &lt; 0.001 for all). Conclusion There is a positive correlation between gastric Hp infection and intestinal Hp enrichment. Intestinal Hp enrichment has a statistically significant effect on the clinical and pathological features of colorectal adenoma.</jats:p

PDIA3 gene induces visceral hypersensitivity in rats with irritable bowel syndrome through the dendritic cell-mediated activation of T cells

This study investigated the mechanism of protein disulfide-isomerase A3 (PDIA3)-induced visceral hypersensitivity in irritable bowel syndrome (IBS). Rats were treated with saline (control), acetic acid and restraint stress (IBS model), empty vector (RNAi control) and PDIA3-RNAi vector (PDIA3-RNAi). Mesenteric lymph node DCs (MLNDCs) and splenic CD4+/CD8+ T cells were isolated for co-cultivation. Compared with control, MLNDCs co-cultured with CD4+ or CD8+ T cells showed an increased ability to promote T cell proliferation and produced more IL-4 or IL-9 secretion. Compared with the RNAi control, MLNDCs from the PDIA3 knockdown models were less effective in promoting the proliferation of CD4+/CD8+ T cells. It is concluded that PDIA3 plays an important role in the development of IBS through the DC-mediated activation of T cells, resulting in degranulation of MCs and visceral hypersensitivity

Table1_Effects of Massa Medicata Fermentata on the intestinal pathogenic flagella bacteria and visceral hypersensitivity in rats with irritable bowel syndrome.XLSX

Objective: To investigate the effect of Massa Medicata Fermentata (MMF) on the changes of pathogenic flagellar bacteria and visceral hypersensitivity in rats with diarrhea irritable bowel syndrome (IBS-D).Methods: Thirty adult SD rats were randomly divided into normal control group (n = 10), model control group (n = 10), and MMF group (n = 10). Acetic acid enema combined with restraint stress was used to build the IBS-D visceral hypersensitivity model; Abdominal withdrawal reflex (AWR) test was used to assess the visceral sensitivity of rats; 16SrRNA sequencing was used to analyze the changes of intestinal bacteria in each group, and the content of pathogenic flagellated bacteria were quantitatively counted; The content of flagellin in colonic mucosa was detected by ELISA; TLR5 protein in colonic mucosa of rats was detected by Western Blot.Results: After IBS-D modeling, the visceral sensitivity of rats was significantly higher in the model control group than that in the normal control group (p = 0.0061), while it was significantly decreased in MMF group compared with the model control group (p = 0.0217), but without significant difference compared with the normal control group (p = 0.6851). The number of fecal Bifidobacterium and Lactobacillus in the model group were significantly decreased compared with the normal control group (p Conclusion: MMF can reduce visceral hypersensitivity by decreasing the content of pathogenic flagellated bacteria and their flagellin and inhibiting its specific receptor TLR5 protein expression in colonic mucosa in IBS-D rats.</p

Single-Atom Mn-N-4 Site-Catalyzed Peroxone Reaction for the Efficient Production of Hydroxyl Radicals in an Acidic Solution

The peroxone reaction between O-3 and H2O2 has been deemed a promising technology to resolve the increasingly serious water pollution problem by virtue of the generation of superactive hydroxyl radicals ((OH)-O-center dot), but it suffers greatly from an extremely limited reaction rate constant under acidic conditions (ca. less than 0.1 M-1 s(-1) at pH 3). This article describes a heterogeneous catalyst composed of single Mn atoms anchored on graphitic carbon nitride, which effectively overcomes such a drawback by altering the reaction pathway and thus dramatically promotes (OH)-O-center dot generation in acid solution. Combined experimental and theoretical studies demonstrate Mn-N-4 as the catalytically active sites. A distinctive catalytic pathway involving HO2 center dot formation by the activation of H2O2 is found, which gets rid of the restriction of HO2- as the essential initiator in the conventional peroxone reaction. This work offers a new pathway of using a low-cost and easily accessible single-atom catalyst (SAC) and could inspire more catalytic oxidation strategies

Single-Atom Mn–N₄ Site-Catalyzed Peroxone Reaction for the Efficient Production of Hydroxyl Radicals in an Acidic Solution

The peroxone reaction between O3 and H2O2 has been deemed a promising technology to resolve the increasingly serious water pollution problem by virtue of the generation of superactive hydroxyl radicals (•OH), but it suffers greatly from an extremely limited reaction rate constant under acidic conditions (ca. less than 0.1 M–1 s–1 at pH 3). This article describes a heterogeneous catalyst composed of single Mn atoms anchored on graphitic carbon nitride, which effectively overcomes such a drawback by altering the reaction pathway and thus dramatically promotes •OH generation in acid solution. Combined experimental and theoretical studies demonstrate Mn–N4 as the catalytically active sites. A distinctive catalytic pathway involving HO2• formation by the activation of H2O2 is found, which gets rid of the restriction of HO2– as the essential initiator in the conventional peroxone reaction. This work offers a new pathway of using a low-cost and easily accessible single-atom catalyst (SAC) and could inspire more catalytic oxidation strategies