A cyanine-derivative photosensitizer, CYBF₂, was synthesized for photodynamic therapy of cancer. The photosensitizer can be activated by red-light with enhanced photostability compared to traditional cyanine photosensitizers. CYBF₂ was able to generate singlet oxygen inside the cell mitochondria, which efficiently resulted in apoptosis of cancer cells.

Esophageal leiomyomas, the most common benign primary tumors of the esophagus, are esophageal subepithelial lesions treated by surgery traditionally. In recent years, endoscopic submucosal dissection and related endoscopic treatment techniques are adopted by endoscopists to resect gastrointestinal submucosal tumors. But if a giant esophageal leiomyoma approaches the esophagus entrance and originates from the deep layer of muscularis propria, it will be difficult for both endoscopic resection and surgical treatment. Especially, endoscopic resection has a high risk of huge perforation difficult to be sutured. A 72-year-old man with dysphagia underwent gastroscopy examination which indicated a large submucous eminence lesion, about 18–24 cm from the incisors. Endoscopic ultrasonography revealed the lesion was hypoechoic and originated from the muscularis propria with a clear boundary. The patient refused invasive surgical resection. Then, an en bloc endoscopic full-thickness resection was performed, which perforation was successfully closed with purse-string sutures using a novel endoloop device through standard single-channel endoscopy. Histopathologic examination showed an esophageal leiomyoma. This endoscopic procedure may be an alternative to avoid surgery for the removal of a giant upper esophagus tumor from muscularis propria layer.

Traditional chemotherapeutic drugs have limitations due to their non-targeted ability toward cancer cells. Stimuli-activatable prodrugs are designed to overcome these obstacles. However, the real-time monitoring of stimuli-activatable theranostic prodrugs still poses challenges. Herein, a prodrug (Fe–SS–HCy), consisting of a ferrocene-modified hemicyanine linked via a disulfide bond, is synthesized for anticancer imaging and therapy. Before activation, the toxicity of Fe–SS–HCy is low. The fluorescence of Fe–SS–HCy is quenched by ferrocene due to photoinduced electron transfer. After being taken up by cancer cells, the intracellular GSH activates Fe–SS–HCy, which releases HCy. The fluorescence of HCy is restored and selectively accumulates in the mitochondria, which further produce reactive oxygen species (ROS) to induce cancer cell death. Thus, this “off-on” fluorogenic HCy presents a new strategy for monitoring prodrug activation in real-time and for enhancing therapeutic efficacy with reduced side effects.

Colon adenocarcinoma (COAD) is highly malignant tumor in the gastrointestinal tract, and reliable biomarkers for predicting its prognosis are remain lacking. MIER Family Member 2 (MIER2) has been implicated in tumor biology, yet its role in COAD remains unclear. MIER2 expression in COAD was analyzed using TCGA and UALCAN databases. Survival analysis, Cox regression, and nomogram construction were performed to evaluate its prognostic value. Functional enrichment analysis was conducted via LinkedOmics. Immune infiltration was assessed using ESTIMATE and CIBERSORT algorithms. Additionally, the effect of MIER2knockdown on the proliferation, and migration of SW480 cell was evaluated. The expression of MIER2 was significantly higher in COAD tissues and associated with a poorer OS, DSS and PFI. Multivariate analysis confirmed MIER2 as an independent prognostic factor. Co-expressed gene analysis revealed enrichment in immune-related pathways, including type I interferon signaling and macrophage activation. In addition, MIER2 expression was associated with altered immune infiltration. MIER2 knockdown suppressed SW480 cell proliferation and migration, and RNA-seq further indicated that this might be related to the intrinsic apoptotic signaling pathway. High expression of MIER2 is associated with poor prognosis and immune cell infiltration, and it serve as a novel prognostic biomarker and potential therapeutic target for COAD.

A 72-year-old woman was treated with endotracheal intubation and mechanical ventilation for shock caused by herbicide poisoning. After extubation she presented with cough. Tracheoscopy and gastroscopy both showed a perforation measuring about 1 cm ([Fig. 1 a, b]). The tracheoesophageal fistula (TEF) was treated with a purse-string suture via a gastroscope (GIF-Q260J; Olympus, Tokyo, Japan) ([Video 1]). In brief, an endoloop (Leo Medical, Changzhou, China) was inserted by forceps and anchored onto the full thickness of the edge of the fistula, including both the esophageal wall and the tracheal wall, with a titanium clip (Micro-Tech, Nanjing, China) ([Fig. 1 c]). After adjustment of the angle, three additional repositionable clips were used to secure the endoloop on different sides of fistula. The removable hook was then inserted and connected with the ring on the tail of the endoloop, which was tightened to pull the edges of the fistula together. The hook was then removed and the TEF was closed ([Fig. 1 d]). To further strengthen the closure of the fistula, an endoclip was added to clamp the still visible small hole ([Fig. 1 e]). The patient was put on nasal feeding after operation and her cough took a turn for the better. One month later, gastroscopy showed that the endoclips and endoloop had fallen off and the fistula was reduced to 0.3 cm, which was clamped with three clips ([Fig. 2]). Another 3 months later, gastroscopy and upper gastrointestinal radiography revealed the fistula to have closed ([Fig. 3]). Video 1 Purse-string suture combined with titanium clips using a single-channel gastroscope for the closure of postintubation tracheoesophageal fistula in a 72-year-old woman. TEF is a severe complication of endotracheal intubation [1]. Owing to the high position of postintubation TEF, it is difficult to place a tracheal or esophageal stent, and surgical correction is usually the only solution [2]. In our case, we performed a purse-string suture to reduce the fistula, and then successively closed the reduced fistula with titanium clips. This endoscopic procedure may be an alternative to surgery for postintubation TEF. Endoscopy_UCTN_Code_TTT_1AO_2AI Publication Date: 28 February 2022 (online) © 2022. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany