Objective: To report our endoscopic outcomes and explore the effects of duration of impaction and anesthetic methods on the endoscopic removal of foreign bodies in the upper gastrointestinal tract. Methods: All consecutive patients with suspected foreign body (FB) ingestion between January 2013 and June 2016 were enrolled. Demographic, clinical and endoscopic data were collected and analyzed. Results: A total of 1294 patients aged seven months to 94 years were enrolled. Odynophagia (415 cases, 32.1%), FB sensation (340 cases, 26.3%) and sore throat (267 cases, 20.1%) were the most frequent complaints. The duration of FB impaction ranged from 4 h to over two years. Anatomically, foreign bodies were most commonly located in the esophagus (n = 1025, 86.9%). Bony foreign bodies comprised the majority of identified foreign bodies. The most common underlying pathology was esophageal stricture (38 cases, 53.5%). Nearly half of the patients (49.9%) developed complications. As the duration of impaction increased, the success rate by endoscopy decreased (p < .001), and the complication rate increased (p < .001). Endoscopic management under general anesthesia didn’t improve the success rate or lower the complication rate compared with topical pharyngeal anesthesia (p = .793 and p = .085). Age ≥60, duration of impaction longer than one day, impaction in the esophagus, and sharp foreign bodies were identified as risk factors for complications. Conclusions: Delayed flexible endoscopy in patients, especially elderly patients, with sharp FB impactions in the esophagus results in worse endoscopic outcomes. Endoscopic management under general anesthesia did not improve the therapeutic results compared with topical pharyngeal anesthesia.

Previous studies reported that administration of somatostatin (SST) to human patients mitigated their diarrheal symptoms. Octreotide (an analog of SST) treatment in animals resulted in upregulation of sodium/hydrogen exchanger 8 (NHE8). NHE8 is important for water/sodium absorption in the intestine, and loss of NHE8 function results in mucosal injury. Thus we hypothesized that NHE8 expression is inhibited during colitis and that SST treatment during pathological conditions can restore NHE8 expression. Our data showed for the first time that NHE8 is expressed in the human colonic tissue and that NHE8 expression is decreased in ulcerative colitis (UC) patients. We also found that octreotide could stimulate colonic NHE8 expression in colitic mice. Furthermore, the somatostatin receptor 2 (SSTR2) agonist seglitide and the somatostatin receptor 5 (SSTR5) agonist L-817,818 could restore NHE8 expression via its role in suppressing ERK1/2 phosphorylation. Our study uncovered a novel mechanism of SST stimulation of NHE8 expression in colitis.

Overweight and obesity was considered as a risk factor for colorectal cancer (CRC), and CRC development may be due to exposure during one’s youth. Metabolic syndrome and insulin resistance seem to play an important role in the underlying mechanisms. Even though several studies indicated the association between BMI at young age and CRC risks, an identified founding is still lacked. Therefore, we conducted a meta-analysis and a dose-response analysis to quantify the association between BMI at young age and CRC risks with relative accuracy. We searched the PubMed, Embase, Medline and Cochrane Library databases for articles published before Sep. 15, 2019. Fifteen articles with 2 520 091 participants were included. Risk for CRC was estimated using relative risks (RR) and 95% confidence intervals (CIs). Compared with individuals with normal weight, overweight and obese young adults had a significantly higher risk of CRC (relative risks (RR):18%, 95% CI:1.08, 1.28； RR:32%, 95% CI: 1.11, 1.56, respectively). However, this correlation may not exist for obese women (RR: 1.22, 95% CI: 0.99, 1.51); Overweight may not a risk factor for rectal cancer (RC) (RR: 1.12, 95% CI: 0.97, 1.29). In the dose-response analysis, we observed a linear relationship between BMI at a young age and CRC risk, with each 1 kg/m² increment associated with a 2% increased risk. Higher BMI at a young age was positively associated with CRC risk, which indicates that weight control since a young age was needed.

Postoperative pain (POP) can promote tumor recurrence and reduce the cancer patient's quality of life. However, POP management has always been separated from tumor treatment in clinical practice, and traditional postoperative analgesia using opioids is still unsatisfactory for patients, which is not conducive to tumor treatment. Here, ropivacaine, a popular amide-type LA, was introduced into a Pluronic F127 hydrogel. Postoperative analgesia with ropivacaine-loaded hydrogels reduced the incidence of high-dose ropivacaine-induced convulsions and prolonged pain relief for more than 16 h. More interestingly, ropivacaine-loaded hydrogel was found to upregulate major histocompatibility complex class I (MHC-I) in tumor cells by impairing autophagy. Therefore, a hydrogel co-dopped with ropivacaine and TLR7 agonist imiquimod (PFRM) was rationally synthesized. After postoperative analgesia with PFRM, imiquimod primes tumor-specific CD8⁺T cells through promoting DCs maturation, and ropivacaine facilitates tumor cells recognition by primed CD8⁺T cells through upregulating MHC-I. Consequently, postoperative analgesia with PFRM maximumly increases CD8⁺T cells infiltration into residual tumor tissue and prevents tumor recurrence. Overall, this study for the first time provides an LA-based approach for simultaneous long-lasting postoperative analgesia and prevention of tumor recurrence.