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BACKGROUND AND AIMS: To verify the safety and efficacy of over-the-scope clip (OTSC)-assisted endoscopic full-thickness resection (EFTR) for the excision of stromal tumors. MATERIAL AND METHODS: Forty patients with gastric stromal tumors treated in the Department of Gastroenterology, Binzhou Medical University Hospital from December 2015 to March 2017 were included in this study. The surgical procedures included marking the lesion boundaries, cutting open the top surface of the lesion, installing an OTS, sucking the lesion into the transparent cap of the anatomical clip which was then released, application of an endoloop for EFTR, and confirming the complete resection and pathological examination of the lesion. Statistical analysis of the tumor site and size, operation time, success rates, complications, pathological examination results, and follow-up status was performed. RESULTS: The average operation duration was 38.40 ± 24.9 min. Three cases had an incomplete resection, but the lesion was later found to have fallen off together with the OTSC. Therefore, the treatment success rate was 100%. Postoperative pathological examination revealed leiomyomas in four cases and stromal tumors in the remaining 36 cases. CONCLUSIONS: OTSC-assisted EFTR is safe and effective for resection of gastrointestinal stromal tumors, especially for those <20 mm in size.

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A number of studies have shown that obesity is implicated in the susceptibility to several cancers. However, the association between obesity and cholangiocarcinoma remains unclear. This meta-analysis aimed to quantitatively assess the association between overweight or obesity and the incidence of cholangiocarcinoma. A literature search was performed for cohort and case-control studies published from 1996 to 2013 using PubMed, Cochrane, and EMBASE databases. Studies were included if they reported odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) of cholangiocarcinoma with respect to obesity or overweight. Normal weight, overweight, and obesity were defined when the body mass index (BMI) was 18.5-24.9, 25-29.9, and ≥ 30 kg/m(2), respectively. Excess body weight was defined as BMI ≥ 25 kg/m(2). Ten studies met the inclusion criteria, which included five cohort and five case-control studies. Compared with normal weight, being overweight (pooled OR 1.30, 95 % CI 1.13-1.49), obesity (pooled OR 1.52, 95 % CI 1.13-1.89), and excess body weight (pooled OR 1.37, 95 %CI 1.22-1.55) were significantly associated with cholangiocarcinoma. The funnel plot revealed no evidence for publication bias. Obesity is associated with the increased risk of cholangiocarcinoma, which needs to be confirmed by long-term cohort studies.

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AIM: To investigate the effect of Lactobacillus bulgaricus (LBG) on the Toll-like receptor 4 (TLR4) pathway and interleukin-8 (IL-8) production in SGC-7901 cells treated with Helicobacter pyloriSydney strain 1 lipopolysaccharide (H pyloriSS1-LPS). METHODS: SGC-7901 cells were treated with H pyloriSS1-LPS in the presence or absence of pretreatment for 1 h with viable LBG or supernatant recovered from LBG culture MRS broth (LBG-(s)). Cellular lysates were prepared for Western blot with anti-TLR4, anti-transforming growth factor beta-activated kinase 1 (TAK1), anti-phospho-TAK1, anti-nuclear factor kappaB (NF-kappaB), anti-p38 mitogen-activated protein kinase (p38MAPK), and anti-phospho-p38MAPK antibodies. The amount of IL-8 in cell culture medium was measured by ELISA. RESULTS: H pyloriSS1-LPS up-regulated the expression of TLR4, stimulated the phosphorylation of TAK1, subsequently enhanced the activation of NF-kappaB and the phosphorylation of p38MAPK in a time-dependent manner, leading to augmentation of IL-8 production in SGC-7901 cells. Viable LBG or LBG-(s) pretreatment attenuated the expression of TLR4, inhibited the phosphorylation of TAK1 and p38MAPK, prevented the activation of NF-kappaB, and consequently blocked IL-8 production. CONCLUSION: H pyloriSS1-LPS induces IL-8 production through activating TLR4 signaling in SGC-7901 cells and viable LBG or LBG-(s) prevents H pyloriSS1-LPS-mediated IL-8 production via inhibition of the TLR4 pathway.

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OBJECTIVE: In vitro to investigate the regulation effects of Lactobacillus acidophilus ATCC4356 and L. bulgaricus (LB) on the activation of NF-kB and IL-8 secretion of SGC7901 cell, which Helicobacter pylori induced. METHODS: SGC7901 cell was cultured to reach the exponential growth phase, then adjusted to cell concentration (2.5 x 10(5)/mL), and planted into six shadow mask and incubated for 24 hours. Until reaching exponential growth phase, the cultured ATCC4356 and LB were adjusted to different concentration to incubation with SGC7901 cell together for one hour, and then added H. pylori into them for culturing 3 hours. For the contrast analysis of result, the experiment subgroups were designed as follow: normal control, H. pylori stimulating group (H. pylori group), ATCC4356 intervention group (ATCC4356 group) and LB intervention group (LB group). The nuclear factor-kB of SGC7901 cell was detected by immunohistochemistry. The release of IL-8 in cells was detected by ELISA. RESULTS: The percentage of NF-kB p65 positive nuclei-stained cell and the secreting level of IL-8 from cells in H. pylori group significantly increased compared with those in control group (P < 0.01). When the Lactobacillus concentration was 3 x 10(6) cfu/mL, 3 x 10(7) cfu/mL and 3 x 10(8) cfu/mL respectively, the percentage of NF-kB p65 positive nuclei-stained cell of ATCC4356 group was significantly decreased compared with that of H. pylori group (P < 0.01). When the Lactobacillus concentration was 3 x 10(6) cfu/ mL and 3 x 10(7) cfu/mL respectively, the IL-8 secretory volume of cells of ATCC4356 group could be significantly decreased compared with that of H. pylori group (P < 0.01). When the Lactobacillus concentration was 3 x 10(6) cfu/ mL, 3 x 10(7) cfu/mL and 3 x 10(8) cfu/mL respectively, the percentage of NF-kB p65 positive nuclei-stained cell of LB group was significantly decreased compared with that of H. pylori group (P < 0.05). When the Lactobacillus concentration was 3 x 10(7) cfu/mL or 3 x 10(8) cfu/mL respectively, the cell IL-8 secretory volume of LB group was significantly decreased compared with that of H. pylori group (P < 0.05). However, if the level of Lactobacillus concentration showed too high, the ATCC4356 and LB might have no above mentioned inhibitory action, the percentage of NF-kB p65 positive nuclei-stained cell and the level of IL-8 secretion of cells in those experiment groups significantly increased compared with those in H. pylori group. CONCLUSION: In some concentration range, both ATCC4356 and LB can inhibit the cell inflammatory reaction induced by H. pylori, but if the concentration is too high, they may make the inflammatory reaction become more serious. These can explain in partial why lactobacillus as primary common bacterium maintains the proper proportion concentration is very important for the keeping on microecological balance in stomach.

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