No abstract

The clinical scenario of pediatric liver disease is becoming more intricate due to changes in the disease spectrum, in which an increasing number of inherited/ metabolic liver diseases are reported, while infectious diseases show a decreasing trend. The similar clinical manifestations caused by inherited/metabolic diseases might be under-recognized or misdiagnosed due to nonspecific characteristics. A delayed visit to a doctor due to a lack of symptoms or mild symptoms at an early stage will result in late diagnosis and treatment. Moreover, limited diagnostic approaches, especially liver biopsy, are not easily accepted by pediatric patients, leading to challenges in etiological diagnosis. Liver dysfunction due to inherited/metabolic diseases is often caused by a variety of metabolites, so precision treatment is difficult; symptomatic treatment is a compelling option for inherited disorders.

Liver cancer cells evade immune surveillance and anticancer response through various pathways, including the programmed death-ligand 1 (PD-L1)/programmed death-1 (PD-1) immune checkpoint axis that exhausts CD8 + T cells. Inhibitors or antibodies of the PD-L1/PD-1 signaling axis are considered promising drugs for cancer immunotherapy and exhibit favorable clinical responses. However, adverse effects, immune tolerance, and delivery barriers of most patients limit the clinical application of PD-L1/PD-1 antibodies. Thus, it is critical to develop a novel delivery strategy to enhance anticancer immunotherapy. In this study, we bioengineered cell membrane-derived nanovesicles (NVs) presenting PD-1 proteins and dibenzocyclooctyne (DBCO) to encapsulate 1-methyltryptophan (1-MT)

Background & Aims: Endoscopic balloon dilatation has become the first line treatment for benign esophageal strictures; It is important to know the factors predicting successful outcome to assist in selecting optimal protocol to obtain the best outcome and avoid as many complication as possible. This study aimed to assess the factors predicting outcome of endoscopic balloon dilatation treatment for esophageal stricture in children. Methods: All the patients with benign esophageal stricture treated by endoscopic balloon dilatation from January 2010 to December 2014 were included. All procedures were performed under tracheal intubation and intravenous anesthesia using the 3rd grade controlled radial expansion balloon with the gastroscope. Outcomes were recorded and predictors for outcomes were analyzed. Results: A total of 170 dilations were completed in 64 patients. The success rate was 96.9%. The rates of response, complication, and recurrence were 96.77%, 8.06%, and 3.33%, respectively. The number of dilatation sessions and complications were significant higher in patients with smaller diameter strictures (P = 0.013, 0.023), and in patients with multiple structures (P = 0.014, 0.004); more complication and recurrences were seen in patients with longer strictures (P = 0.001, 0.012). The longer the interval between surgery and first dilatation the more sessions and the poorer the response in the patients with anastomotic esophageal strictures (p = 0.017, 0.024). Conclusions: The diameter, length and number of stricture were the most important risk factors for poor outcomes of endoscopic balloon dilatation treatment of esophageal stricture.