Bi, Yan

Abstract Background Pancreatic cysts (PC) are increasingly detected through abdominal imaging, prompting exploration of alternatives such as endoscopic ultrasound-guided pancreatic cyst ablation (EUS-PCA) due to the risks and costs associated with surgery. This study conducts a systematic review and meta-analysis of EUS-PCA's short-term efficacy and complications for PC management. Methods A systematic review and meta-analysis were carried out on PubMed, Ovid, Cochrane, and TRIP electronic databases. The primary outcome was cyst resolution (partial and complete) and persistence on imaging 12 months after ablation. The secondary outcome was procedure-related adverse events. Results Eight studies were eligible for analysis. Complete cyst resolution on imaging 12 months after EUS ablation was 50% [95% CI 36, 63, I2 = 85.31%]. Partial cyst resolution was 27% [95% CI 15, 41, I2 = 87.07%], and cyst persistence was 17% [95% CI 11, 24, I2 = 62.11%]. The rate of complete resolution varied depending on the treatment agent (for ethanol 29% [95% CI 10, 53], lauromacrogol 51% [95% Cl 36, 67], ethanol and paclitaxel 63% [95% CI 48, 76], paclitaxel and gemcitabine 67% [95% CI 45, 83], ethanol, paclitaxel and gemcitabine 61% [95% CI 39, 80]). Post-procedure adverse events included abdominal pain in 4% [95% CI 0, 11], pancreatitis in 3% [95% CI 1, 5], and fever in 1% [95% CI 0, 3] of all patients. Conclusion The treatment of pancreatic cysts with EUS ablation results in acceptable levels of complete resolution, and low incidence of severe adverse events. The effectiveness of this treatment is further enhanced when chemoablative agents are employed.

Abstract Background & Aims: Coronavirus-19 (COVID-19) due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) is an ongoing global pandemic causing more than three million deaths. Protease inhibitors had been shown to decrease viral entry. However, the role of dabigatran, an inhibitor of multiple proteases, on coronavirus remains unknown.Methods: MRC-5 cells, HCT-8, or Huh-7 cells were infected with Beta-coronavirus OC43 and SARS-CoV-2. Cytopathic effects (CPE) were monitored by imaging. Viral load was measured by quantitative RT-PCR. Viral protein was detected by Western blot.Results: Camostat, a serine protease inhibitor, had no effect on the replication of OC43 and SARS CoV-2 even at higher doses. Dabigatran inhibited replication, viral entry and CPE of OC43 in a dose-dependent manner. Dabigatran and Remdisivir synergistically inhibited OC43 virus replication. Conclusions: Dabigatran may be beneficial in treating SARS-CoV-2 both for anticoagulation and viral replication inhibition need to be evaluated further.