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Antitumor effects of a novel photosensitizer-mediated photodynamic therapy and its influence on the cell transcriptome

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Oncology Research 2024年第5期32卷 911-923页

作者： JINGJING CHEN DAN WANG ZEQUN WANG MENGYUAN HAN HOUQING YIN WENTING ZHOU RIBAI YAN YAN PAN department of Pharmacology School of PharmacyChangzhi Medical CollegeChangzhiChina2 Department of PharmacologySchool of Basic Medical SciencesHealth Science CenterPeking UniversityBeijingChina3 Beijing Key Laboratory of Tumor Systems BiologyPeking UniversityBeijingChina4 Department of PharmacologyXinjiang Medical UniversityUrumqiChina5 School of Pharmaceutical SciencesPeking UniversityBeijingChina

Photodynamic therapy(PDT)is a promising cancer *** study investigated the antitumor effects and mechanisms of a novel photosensitizer meso-5-[ρ-diethylene triamine pentaacetic acid-aminophenyl]−10,15,20-triphenyl-porphyrin(DTP)mediated PDT(DTP-PDT).Cell viability,reactive oxygen species(ROS),and apoptosis were measured with a Cell Counting Kit-8 assay,DCFH-DA fluorescent probe,and Hoechst staining,*** apoptosis-and autophagy-related proteins were examined using western *** sequencing was used to screen differentially expressed mRNAs(DERs),and bioinformatic analysis was performed to identify the major biological events after *** results show that DTP-PDT inhibited cell growth and induced ROS generation in MCF-7 and SGC7901 *** ROS scavenger N-acetyl-L-cysteine(NAC)and the P38 MAPK inhibitor SB203580 alleviated DTP-PDT-induced ***-PDT induced cell apoptosis together with upregulated Bax and downregulated Bcl-2,which could also be inhibited by NAC or *** level of LC3B-Ⅱ,a marker of autophagy,was increased by DTP-PDT.A total of 3496 DERs were obtained after *** Ontology and Kyoto Encyclopedia of genes and Genomes analyses indicated that DERs included those involved in cytosolic ribosomes,the nuclear lumen,protein binding,cell cycle,protein targeting to the endoplasmic reticulum,and ribosomal DNA *** Ontology and Reactome enrichment analyses indicated that DERs were associated with a variety of cancers and cell cycle ***-protein interaction results demonstrated that cdk1 and rps27a ranked in the top 10 interacting ***,DTP-PDT could inhibit cell growth and induce cell apoptosis and autophagy,partly through ROS and the P38 MAPK signaling *** associated with the cell cycle,ribosomes,DNA replication,and protein binding may be the key changes in DTP-PDT-mediated cytotoxicity.

关键词： Photodynamic therapy ROS Apoptosis Autophagy Bioinformatic analysis

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tumor-derived DEFB1 induces immune tolerance by inhibiting maturation of dendritic cell and impairing CD8+T cell function in esophageal squamous cell carcinoma

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Chinese Journal of Cancer Research 2024年第4期36卷 351-367页

作者： Jingjing Duan Haotian Wang Minglu Liu Yin Chen Ning Li Jieqiong Liu Lingxiong Wang Lin Li Yaru Liu Pengfei Dong Xiuxuan Wang Zhongyi Fan Shunchang Jiao Tianjin Medical University Cancer Institute and Hospital National Clinical Research Center for CancerTianjin’s Clinical Research Center for CancerTianjin Key Laboratory of Digestive CancerKey Laboratory of Cancer Prevention and TherapyTianjin 300060China department of Oncology the Fifth Medical Center of Chinese PLA General HospitalBeijing 100039China Beijing DCTY Biotech CO. LTD.Beijing 102200China department of Biotherapy center Shenzhen Third People’s HospitalSecond Hospital Affiliated to Southern University of Science and TechnologyShenzhen 518112China

Objective:CD8+T cells are the key effector cells in the anti-tumor immune *** mechanism underlying the infiltration of CD8+T cells in esophageal squamous cell carcinoma(ESCC)has not been clearly ***:Fresh ESCC tissues were collected and grouped according to the infiltration density of CD8+T *** the transcriptome sequencing on these samples and the combined analyses with The Cancer Genome Atlas(TCGA)ESCC data,a secreted protein DEFB1 was selected to explore its potential role in the infiltration of CD8+T *** analyses,histological verification and in vitro experiments were then ***:DEFB1 was highly expressed in ESCC,and the high expression of DEFB1 was an independent risk factor for overall *** the up-regulation or down-regulation of DEFB1 did not affect the proliferation,migration and apoptosis of ESCC cells,we speculated that the oncogenic effect of DEFB1 was achieved by regulating microenvironmental *** analyses suggested that DEFB1 might play a major role in the inflammatory response and anti-tumor immune response,and correlate to the infiltration of immature dendritic cell(imDC)in *** analyses further confirmed that there were less CD8+T cells infiltrated,less CD83+mature DC(mDC)infiltrated and more CD1a+imDC infiltrated in those ESCC samples with high expression of *** the treatment with recombinant DEFB1 protein,the maturation of DC was hindered significantly,followed by the impairment of the killing effects of T cells in both 2D and 3D culture in ***:tumor-derived DEFB1 can inhibit the maturation of DC and weaken the function of CD8+T cells,accounting for the immune tolerance in *** role of DEFB1 in ESCC deserves further exploration.

关键词： CD8+T cells DEFB1 dendritic cells esophageal squamous cell carcinoma tumor immune microenvironment

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A lactate‐responsive gene signature predicts the prognosis and immunotherapeutic response of patients with triple‐negative breast cancer

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Cancer Innovation 2024年第4期3卷 26-42页

作者： Kaixiang Feng Youcheng Shao Jun Li Xiaoqing Guan Qin Liu Meishun Hu Mengfei Chu Hui Li Fangfang Chen Zongbi Yi Jingwei Zhang department of Breast and Thyroid Surgery Zhongnan Hospital of Wuhan UniversityHubei Key Laboratory of Tumor Biological BehaviorsHubei Cancer Clinical Study CenterWuhanChina department of Pathology and Pathophysiology Hubei Provincial Key Laboratory of Developmentally Originated DiseaseTaiKang Medical School(School of Basic Medical Sciences)Wuhan UniversityWuhanChina department of Human Anatomy TaiKang Medical School(School of Basic Medical Sciences)Wuhan UniversityWuhanChina department of Radiation and Medical Oncology Zhongnan Hospital of Wuhan UniversityHubei Key Laboratory of Tumor Biological BehaviorsHubei Cancer Clinical Study CenterWuhanChina

Background:Increased glycolytic activity and lactate production are characteristic features of triple‐negative breast cancer(TNBC).The aim of this study was to determine whether a subset of lactate‐responsive genes(LRGs)could be used to classify TNBC subtypes and predict patient ***:Lactate levels were initially measured in different breast cancer(BC)cell ***,MDA‐MB‐231 cells treated with 2‐Deoxy‐Dglucose or L‐lactate were subjected to RNA sequencing(RNA‐seq).The gene set variation analysis algorithm was utilized to calculate the lactate‐responsive score,conduct a differential analysis,and establish an association with the extent of immune *** clustering was then employed to classify TNBC *** immune dysfunction and exclusion,cibersort,single‐sample gene set enrichment analysis,and EPIC,were used to compare the tumor‐infiltrating immune cells between TNBC subtypes and predict the response to ***,a prognostic model was developed by combining 98 machine learning algorithms,to assess the predictive significance of the LRG *** predictive value of immune infiltration and the immunotherapy response was also ***,the association between lactate and various anticancer drugs was examined based on expression profile similarity ***:We found that the lactate levels of TNBC cells were significantly higher than those of other BC cell *** RNA‐seq,we identified 14 differentially expressed LRGs in TNBC cells under varying lactate ***,this LRG signature was associated with interleukin‐17 signaling pathway dysregulation,suggesting a link between lactate metabolism and immune ***,the LRG signature was used to categorize TNBC into two distinct subtypes,whereby Subtype A was characterized by immunosuppression,whereas Subtype B was characterized by immune ***:We identified an LRG signature in TNBC,which could be used

关键词： immunotherapy lactate risk model subtype TNBC

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Precise Planar-Twisted Molecular Engineering to Construct Semiconducting Polymers with Balanced Absorption and Quantum Yield for Efficient Phototheranostics

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Research 2024年第2期2023卷 227-238页

作者： Xiang Su Zhirong Bao Wei Xie Deliang Wang Ting Han Dong Wang Ben Zhong Tang center for AIE Research Shenzhen Key Laboratory of Polymer Science and TechnologyGuangdong Research Center for Interfacial Engineering of Functional MaterialsCollege of Materials Science and EngineeringShenzhen UniversityShenzhen 518060China School of Biomedical and Pharmaceutical Sciences Guangdong University of TechnologyGuangzhou 510006China department of Radiation and Medical Oncology Hubei Key Laboratory of Tumor Biological BehaviorsHubei Cancer Clinical Study CenterZhongnan Hospital of Wuhan UniversityWuhan 430071China department of Materials Chemistry Huzhou UniversityHuzhou 313000China School of Science and Engineering Shenzhen Institute of Aggregate Science and TechnologyThe Chinese University of Hong KongShenzhenGuangdong 518172China

Semiconducting polymers(SPs)have shown great feasibility as candidates for near-infrared-II(NIR-Ⅱ)fluorescence imaging-navigated photothermal therapy due to their strong light-harvesting ability and flexible ***,the fluorescence signal of traditional SPs tends to quench in their aggregate states owing to the strongπ-πstacking,which can lead to the radiative decay pathway shutting *** address this issue,aggregation-induced emission effect has been used as a rational tactic to boost the aggregate-state fluorescence of NIR-Ⅱ*** this contribution,we developed a precise molecular engineering tactic based on the block copolymerizations that integrate planar and twisted segments into one conjugated polymer backbone,providing great flexibility in tuning the photophysical properties and photothermal conversion capacity of *** monomers featured with twisted and planar architectures,respectively,were tactfully incorporated via a ternary copolymerization approach to produce a series of new *** optimal copolymer(SP2)synchronously shows desirable absorption ability and good NIR-Ⅱquantum yield on the premise of maintaining typical aggregation-induced emission characteristics,resulting in balanced NIR-Ⅱfluorescence brightness and photothermal ***-dispersible nanoparticles fabricated from the optimal SP2 show efficient photothermal therapeutic effects both in vitro and in *** in vivo investigation reveals the distinguished NIR-Ⅱfluorescence imaging performance of SP2 nanoparticles and their photothermal ablation toward tumor with prominent tumor accumulation ability and excellent biocompatibility.

关键词： property conducting twisted

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Targeted knockdown of PGAM5 in synovial macrophages efficiently alleviates osteoarthritis

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Bone Research 2024年第1期12卷 215-226页

作者： Yuhang Liu Ruihan Hao Jia Lv Jie Yuan Xuelei Wang Churong Xu Ding Ma Zhouyi Duan Bingjun Zhang Liming Dai Yiyun Cheng Wei Lu Xiaoling Zhang department of Orthopedic Surgery Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine(SJTUSM)Shanghai 200092China National Facility for Translational Medicine Shanghai 200240China Shanghai Frontiers Science center of Genome Editing and Cell therapy Shanghai Key Laboratory of Regulatory BiologySchool of Life SciencesEast China Normal UniversityShanghai 200241China department of Orthopaedic Surgery The Second Hospital of Shanxi Medical UniversityTaiyuan 030001China CAS Key Laboratory of Tissue Microenvironment and tumor Shanghai Institute of Nutrition and HealthChinese Academy of SciencesShanghai 200031China School of Medicine Shanghai UniversityShanghai 200444China

Osteoarthritis(OA)is a common degenerative disease worldwide and new therapeutics that target inflammation and the crosstalk between immunocytes and chondrocytes are being developed to prevent and treat *** attempts involve repolarizing pro-inflammatory M1 macrophages into the anti-inflammatory M2 phenotype in *** this study,we found that phosphoglycerate mutase 5(PGAM5)significantly increased in macrophages in OA synovium compared to controls based on histology of human samples and single-cell RNA sequencing results of mice *** address the role of PGAM5 in macrophages in OA,we found conditional knockout of PGAM5 in macrophages greatly alleviated OA symptoms and promoted anabolic metabolism of chondrocytes in vitro and in ***,we found that PGAM5 enhanced M1 polarization via AKT-mTOR/p38/ERK pathways,whereas inhibited M2 polarization via STAT6-PPARγpathway in murine bone marrow-derived ***,we found that PGAM5 directly dephosphorylated Dishevelled Segment Polarity Protein 2(DVL2)which resulted in the inhibition ofβ-catenin and repolarization of M2 macrophages into M1 *** knockout of both PGAM5 andβ-catenin in macrophages significantly exacerbated osteoarthritis compared to PGAM5-deficient *** by these findings,we successfully designed mannose modified fluoropolymers combined with siPGAM5 to inhibit PGAM5 specifically in synovial macrophages via intra-articular injection,which possessed desired targeting abilities of synovial macrophages and greatly attenuated murine ***,these findings defined a key role for PGAM5 in orchestrating macrophage polarization and provides insights into novel macrophage-targeted strategy for treating OA.

关键词： osteoarthritis metabolism inhibited

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Id2 epigenetically controls CD8^(+)T-cell exhaustion by disrupting the assembly of the Tcf3-LSD1 complex

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Cellular & Molecular immunology 2024年第3期21卷 292-308页

作者： Yiming Li Mingwei Han Haolin Wei Wan Huang Zhinan Chen Tianjiao Zhang Meirui Qian Lin Jing Gang Nan Xiuxuan Sun Shuhui Dai Kun Wang Jianli Jiang Ping Zhu Liang Chen department of Cell Biology of National Translational Science center for Molecular Medicine and department of Clinical immunology of Xijing Hospital Fourth Military Medical UniversityXi’anShaanxi 710032China State Key Laboratory of New Targets Discovery and Drug Development for Major Diseases GanzhouJiangxi341000Xi’anShaanxi 710032China School of Medicine Shanghai UniversityShanghai 200444China

CD8^(+)T-cell exhaustion is a state of dysfunction that promotes tumor progression and is marked by the generation of Slamf6^(+)progenitor exhausted(Tex^(prog))and Tim-^(3+)terminally exhausted(Tex^(term))*** of DNA binding protein 2(Id2)has been shown to play important roles in T-cell development and CD8^(+)T-cell ***,the role of Id2 in CD8^(+)T-cell exhaustion is ***,we found that Id2 transcriptionally and epigenetically regulates the generation of Texprog cells and their conversion to Texterm *** deletion of Id2 dampens CD8^(+)T-cell-mediated immune responses and the maintenance of stem-like CD8^(+)T-cell subpopulations,suppresses PD-1 blockade and increases tumor ***,through its HLH domain,Id2 binds and disrupts the assembly of the Tcf3-Tal1 transcriptional regulatory complex,and thus modulates chromatin accessibility at the Slamf6 promoter by preventing the interaction of Tcf3 with the histone lysine demethylase ***,Id2 increases the abundance of the permissive H3K4me2 mark on the Tcf3-occupied E-boxes in the Slamf6 promoter,modulates chromatin accessibility at the Slamf6 promoter and epigenetically regulates the generation of Slamf6+Texprog *** LSD1 inhibitor GSK2879552 can rescue the Id2 knockout phenotype in tumor-bearing *** of LSD1 increases the abundance of Slamf6^(+)Tim-3^(−)Tex^(prog) cells in tumors and the expression level of Tcf1 in Id2-deleted CD8+T *** study demonstrates that Id2-mediated transcriptional and epigenetic modification drives hierarchical CD8^(+)T-cell exhaustion,and the mechanistic insights gained may have implications for therapeutic intervention with tumor immune evasion.

关键词： Id2 T-cell exhaustion Epigenetic modification Immune evasion

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Environmentally persistent free radicals in PM_(2.5)from a typical Chinese industrial city during COVID-19 lockdown:The unexpected contamination level variation

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Journal of Environmental Sciences 2024年第1期135卷 424-432页

作者： Lingyun Wang Wuduo Zhao Peiru Luo Qingyun He Wenfen Zhang Chuan Dong Yanhao Zhang College of Chemistry Zhengzhou UniversityZhengzhou 450001China center of Advanced Analysis and gene Sequencing Key Laboratory of Molecular Sensing and Harmful Substances Detection TechnologyZhengzhou UniversityZhengzhou 450001China State Key Laboratory of Environmental and Biological Analysis Department of ChemistryHong Kong Baptist UniversityHong Kong 999077China Institute of Environmental Science Shanxi UniversityTaiyuan 030006China

The outbreak of COVID-19 has caused concerns *** reduce the rapid transmission of the virus,strict city lockdown measures were conducted in different *** is the country that takes the earliest home-based quarantine for *** normal industrial and social activities were suspended,the spread of virus was efficiently ***,another merit of the city lockdown measure was noticed,which is the improvement of the air *** levels of multiple atmospheric pollutants were ***,in this work,24 and 14 air fine particulate matter(PM_(2.5))samples were continuously collected before and during COVID-19 city lockdown in Linfen(a typical heavy industrial city in China),and intriguingly,the unreduced concentration was found for environmentally persistent free radicals(EPFRs)in PM_(2.5)after normal life *** primary non-stopped coal combustion source and secondary Cu-related atmospheric reaction may have impacts on this *** cigarette-based assessment model also indicated possible exposure risks of PM_(2.5)-bound EPFRs during lockdown of *** study revealed not all the contaminants in the atmosphere had an apparent concentration decrease during city lockdown,suggesting the pollutants with complicated sources and formation mechanisms,like EPFRs in PM_(2.5),still should not be ignored.

关键词： PM_(2.5) EPFRs COVID-19 City lockdown Health risks

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genetic variation in a heat shock transcription factor modulates cold tolerance in maize

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Molecular Plant 2024年第9期17卷 1423-1438页

作者： Lei Gao Lingling Pan Yiting Shi Rong Zeng Minze Li Zhuoyang Li Xuan Zhang Xiaoming Zhao Xinru Gong Wei Huang Xiaohong Yang Jinsheng Lai Jianru Zuo Zhizhong Gong Xiqing Wang Weiwei Jin Zhaobin Dong Shuhua Yang State Key Laboratory of Plant Environmental Resilience Frontiers Science Center for Molecular Design BreedingCollege of Biological SciencesCenter for Crop Functional Genomics and Molecular BreedingChina Agricultural UniversityBeijing 100193China State Key Laboratory of Maize Bio-breeding National Maize Improvement CenterFrontiers Science Center for Molecular Design BreedingDepartment of Plant Geneticsand BreedingChinaAgricultural UniversityBeijingChina State Key Laboratory of Plant Genomics and National Plant gene Research center Institute of Genetics and Developmental BiologyChinese Academy of SciencesBeijing100101China

Understanding how maize(Zea mays)responds to cold stress is crucial for facilitating breeding programs of cold-tolerant *** extensive utilization of the genome-wide association study(GWAs)approach for exploring favorable natural alleles associated with maize cold tolerance,few studies have successfully identified candidate genes that contribute to maize cold *** this study,we used a diverse panel of inbred maize lines collected from different germplasm sources to perform a GWAS on var-iations in the relative injured area of maize true leaves during cold stress-a trait very closely correlated with maize cold *** identified HsF21,which encodes a B-class heat shock transcription factor(HSF)that positively regulates cold tolerance at both the seedling and germination *** varia-tions in the promoter of the cold-tolerant HSF21Hap1 allele led to increased HSF21 expression under cold stress by inhibiting binding of the basic leucine zipper bziP68 transcription factor,a negative regulator of cold *** integrating transcriptome deep sequencing,DNA affinity purification sequencing,and targeted lipidomic analysis,we revealed the function of HsF21 in regulating lipid metabolism homeo-stasis to modulate cold tolerance in *** addition,we found that HsF21 confers maize cold tolerance without incurring yield ***,this study establishes HsF21 as a key regulator that en-hances cold tolerance in maize,providing valuable genetic resources for breeding of cold-tolerant maize varieties.

关键词： heat shock factor HSF21 cold tolerance natural variation bZiP68 lipid metabolism maize

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Ki-67 Change in Anthracyline-containing Neoadjuvant Chemotherapy Response in Breast Cancer

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Current Medical Science 2024年第1期44卷 156-167页

作者： Zi-guo YANG Le-hao REN Feng WANG Pi-lin WANG Wen-yan WANG Shu-ye LIN department of general Surgery Beijing Tiantan HospitalCapital Medical UniversityBeijing 100070China department of Critical Care Medicine Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China Cancer Research center Beijing Chest HospitalCapital Medical University/Beijing Tuberculosis and Thoracic Tumor Research InstituteBeijing 101149China

Objective Anthracycline-containing regimens are irreplaceable in neoadjuvant chemotherapy(NAC)for breast cancer(BC)at ***,30% of early breast cancer(EBC)patients are resistant to anthracycline-containing chemotherapy,leading to poor prognosis and higher ***-67 is associated with the prognosis and response to therapy,and it changes after *** A total of 105 BC patients who received anthracycline-containing NAC were ***,the optimal model of Ki-67 was selected,and its predictive efficacy was ***(IHC)was used to determine the estrogen receptor(ER),progesterone receptor(PR),and human epidermal growth factor receptor 2(HER-2)status and Ki-67 *** in situ hybridization(FISH)was used to verify the HER-2 when the IHC score was 2+.Results The post-NAC Ki67 level after treatment with anthracycline drugs was lower than pre-NAC Ki-67(19.6%±23.3%vs.45.6%±23.1%,P<0.001).Furthermore,patients with the Ki-67 decrease had a border line higher pathological complete response(pCR)rate(17.2%vs.0.0%,P=0.068),and a higher overall response rate(ORR)(73.6%vs.27.8%,P<0.001),when compared to patients without the Ki-67 *** ΔKi-67 and ΔKi-67%were valuable markers for the prediction of both the pCR rate and *** area under the curve(AUC)for ΔKi-67 on pCR and ORR was 0.809(0.698-0.921)and 0.755(0.655-0.855),respectively,while the AUC for ΔKi-67% on pCR and ORR was 0.857(0.742-0.972)and 0.720(0.618-0.822),*** logistic regression model 1 revealed thatΔKi-67 was an independent predictor for both pCR[odds ratio(OR)=61.030,95% confidence interval(CI)=4.709-790.965;P=0.002]and ORR(OR=10.001,95%CI:3.044-32.858;P<0.001).Multivariate logistic regression model 2 revealed thatΔKi-67%was also an independent predictor for both pCR(OR=408.922,95%CI=8.908-18771.224;P=0.002)and ORR(OR=5.419,95%CI=1.842-15.943;P=0.002).Conclusions The present study results suggest thatΔKi67 andΔKi67%are candidate predictor

关键词： breast cancer change in Ki-67 neoadjuvant chemotherapy anthracycline,response

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Endoscopic-ultrasound-guided biliary drainage with placement of electrocautery-enhanced lumen-apposing metal stent for palliation of malignant biliary obstruction:Updated meta-analysis

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 907-920页

作者： Zu-Xiang Peng Fang-Fang Chen Wen Tang Xu Zeng Hong-Juan Du Ru-Xian Pi Hong-Ming Liu Xiao-Xiao Lu department of Hepatobiliary Surgery Daping HospitalArmy Medical UniversityChongqing 400042China department of Oncology Chongqing General HospitalChongqing UniversityChongqing 401147China department of Gastroenterology and Hepatobiliary Surgery People’s Hospital of Fenggang CountyGuizhou 564200Guizhou ProvinceChina Hepatobiliary and Pancreatic tumor center Chongqing University Cancer HospitalChongqing 400030China

BACKGROUND Endoscopic ultrasound-guided biliary drainage using electrocautery-enhanced(ECE)delivery of lumen-apposing metal stent(LAMS)is gradually being re-cognized as a viable palliative technique for malignant biliary obstruction after endoscopic retrograde cholangiopancreatography(ERCP)***,most of the studies that have assessed its efficacy and safety were small and *** meta-analyses of six or fewer studies that were published 2 years ago were therefore underpowered to yield convincing *** To update the efficacy and safety of ECE-LAMS for treatment of biliary ob-struction after ERCP *** We searched PubMed,EMBASE,and Scopus databases from the inception of the ECE technique to May 13,*** outcome measure was pooled technical success rate,and secondary outcomes were pooled rates of clinical success,re-intervention,and adverse ***-analysis was performed using a random-effects model following Freeman-Tukey double-arcsine transformation in R soft-ware(version 4.1.3).RESULTS Fourteen eligible studies involving 620 participants were ultimately *** pooled rate of technical success was 96.7%,and clinical success was 91.0%.Adverse events were reported in 17.5%of *** reinter-vention rate was 7.3%.Subgroup analyses showed results were generally *** ECE-LAMS has favorable success with acceptable adverse events in relieving biliary obstruction when ERCP is *** consistency of results across most subgroups suggested that this is a generalizable approach.

关键词： Biliary obstruction Biliary drainage Electrocautery-enhanced lumen-apposing metal stents Endoscopic ultrasound Endoscopic retrograde cholangiopancreatography failure

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