AIM:To evaluate the outcome of over-the-scope-clip system(OTSC)for endoscopic treatment of various indications in daily clinical practice in Switzerland.METHODS:This prospective,consecutive case series was conducted a...AIM:To evaluate the outcome of over-the-scope-clip system(OTSC)for endoscopic treatment of various indications in daily clinical practice in Switzerland.METHODS:This prospective,consecutive case series was conducted at a tertiary care hospital from September 2010 to January 2014.Indications for OTSC application were fistulae,anastomotic leakage,perforation,unroofed submucosal lesion for biopsy,refractory bleeding,and stent fixation in the gastrointestinal(GI)tract.Primary technical success was defined as the adequate deployment of the OTSC on the target lesion.Clinical success was defined as resolution of the problem;for instance,no requirement for surgery or further endoscopic intervention.In cases of recurrence,retreatment of a lesion with a second intervention was possible.Complications were classified into those related to sedation,endoscopy,or deployment of the clip.RESULTS:A total of 28 OTSC system applications werecarried out in 21 patients[median age 64 years(range42-85),33%females].The main indications were fistulae(52%),mostly after percutaneous endoscopic gastrostomy tube removal,and anastomotic leakage after GI surgery(29%).Further indications were unroofed submucosal lesions after biopsy,upper gastrointestinal bleeding,or esophageal stent fixation.The OTSC treatments were applied either in the upper(48%)or lower(52%)GI tract.The mean lesion size was 8 mm(range:2-20 mm).Primary technical success and clinical success rates were 85%and 67%,respectively.In53%of cases,the suction method was used without accessories(e.g.,twin grasper or tissue anchor).No endoscopy-related or OTSC-related complications were observed.CONCLUSION:OTSC is a useful tool for endoscopic closure of various GI lesions,including fistulae and leakages.Future randomized prospective multicenter trials are warranted.展开更多
Percutaneous endoscopic gastrostomy(PEG) is a common practice for long-term nutrition of patients who are unable to take oral food. We report of an 85-year old man with a history of recurrent larynx carcinoma and hemi...Percutaneous endoscopic gastrostomy(PEG) is a common practice for long-term nutrition of patients who are unable to take oral food. We report of an 85-year old man with a history of recurrent larynx carcinoma and hemicolectomy many years ago due to unknown reason. Laryngectomy was indicated. Preoperatively a PEG was inserted endoscopically after an abdominal ultrasonography without abnormal findings. Few months after PEG insertion, the patient was evaluated for diarrhea and insufficient feeding without signs of infection or peritonism. An upper endoscopy and computed tomography scan confirmed a buried bumper syndrome with migration of the PEG tube into the colon as a rare complication. He underwent successful colonoscopic removal of the internal bumper and closure of the colonic orifice of the fistula with the over-the-scope-clip system(OTSC). OTSC is an endoscopic device for treatment of bleeding, perforation, leak and fistula in the gastrointestinal tract. To the best of our knowledge, this is the first report of the use of OTSC for colonoscopic closure of a gastrocolocutaneous fistula due to a buried bumper syndrome with transcolonic PEG tube migration.展开更多
At the township level,combining Voronoi diagram and breaking point theory,this paper divides township grade system and its scope of influence in Dafang County of Guizhou Province,and discusses the grade system from sm...At the township level,combining Voronoi diagram and breaking point theory,this paper divides township grade system and its scope of influence in Dafang County of Guizhou Province,and discusses the grade system from small scale perspective.Results show that Dafang County takes Dafang Town as the center,Dashi Town in the north and Shachang Township in the east as auxiliary part,Sanyuan Township,Zhuyuan Township,Babao Township,Pudi Township,Lihua Township,and Dingxin Township as cooperative part,to drive development of 36 townships in Dafang County.Thus,it basically reflects township grade of Dafang County,accords with current development situation,provides certain reference value for system planning and economic zoning of small scale regions,and it is able to improve the accuracy of scope division by completing attribute data and revision of many methods.展开更多
AIM: To compare the new Olympus V-scope (VS) to conventional endoscopic retrograde cholangiopancreati-cography (ERCP). METHODS: Forty-nine patients with previous endoscopic papillotomy who were admitted for interventi...AIM: To compare the new Olympus V-scope (VS) to conventional endoscopic retrograde cholangiopancreati-cography (ERCP). METHODS: Forty-nine patients with previous endoscopic papillotomy who were admitted for interventional ERCP for one of several reasons were included in this single-centre, prospective randomized study. Consecutive patients were randomized to either the VS group or to the conventional ERCP group. ERCP-nave patients who had not undergone papillotomy were excluded. The main study parameters were interventional examination time, X-ray time and dose, and premedication dose (all given below as the median, range) and were investigated in addition to each patient's clinical outcome and complications. Subjective scores to assess each procedure were also provided by the physicians and endoscopy assistants who carried out the procedures. A statistical analysis was carried out using the Wilcoxon rank-sum test.RESULTS: Twenty-five patients with 50 interventions were examined with the VS ERCP technique, and 24 patients with 47 interventions were examined using the conventional ERCP technique. There were no significant differences between the two groups regarding the age, sex, indications, degree of ERCP difficulty, or interventions performed. The main study parameters in the VS group showed a nonsignificant trend towards a shorter interventional examination time (29 min, 5-50 min vs 31 min, 7-90 min, P = 0.28), shorter X-ray time (5.8 min, 0.6-14.1 min vs 6.1 min, 1.6-18.8 min, P = 0.48), and lower X-ray dose (1351 cGy/m2 , 159-5039 cGy/m2 vs 1296 cGy/m2 , 202.2-6421 cGy/m 2 , P = 0.34). A nonsignificant trend towards fewer adverse events occurred in the VS group as compared with the conventional ERCP group (cholangitis: 12% vs 16%, P = 0.12; pain: 4% vs 12.5%, P = 0.33; post-ERCP pancreatitis: 4% vs 12.5%, P = 0.14). In addition, there were no statistically significant differences in assessment by the physicians and endoscopy assistants using subjective questionnaires.CONCLUSION: ERCP using the short-guidewire V-system did not significantly improve ERCP performance or patient outcomes, but it may reduce and simplify the ERCP procedure in difficult settings.展开更多
目的:系统检索并筛选国内外健康服务领域膳食推荐系统相关的文献,梳理、汇总与分析膳食推荐系统的特征、算法及应用场景,为推动膳食推荐系统助力个性化营养提供依据。方法:使用主题词和自由词检索方式在中英文数据库中进行文献检索,检...目的:系统检索并筛选国内外健康服务领域膳食推荐系统相关的文献,梳理、汇总与分析膳食推荐系统的特征、算法及应用场景,为推动膳食推荐系统助力个性化营养提供依据。方法:使用主题词和自由词检索方式在中英文数据库中进行文献检索,检索时限为数据库建库至2024年3月31日,依据Arksey and O′Malley范围综述方法学框架及Joanna Briggs Institute(JBI)证据整合手册,对纳入文献进行信息提取、汇总和分析。结果:共纳入38篇文献。5项研究针对慢性病病人或糖尿病病人进行膳食推荐,其余研究并未明确推荐人群;23项研究的推荐产品为菜谱,6项研究为食材推荐,3项研究为菜品套餐推荐;4项研究为三餐规划推荐;1项研究为食疗处方推荐,另有1项研究为零食推荐。31篇文献采用离线实验进行系统测试,10篇文献采用用户调查进行测试,1篇文献进行了预试验,1篇进行了在线实验测试。结论:推荐系统算法模型的发展从理论层面证明其推荐功能的可实现性,但相关研究仍处于起步阶段,相关报告不完善,评估体系尚未健全,未来膳食推荐系统应通过实践应用对其可用性和效果进行评价,促进膳食推荐系统赋能营养健康,助力膳食管理。展开更多
文摘AIM:To evaluate the outcome of over-the-scope-clip system(OTSC)for endoscopic treatment of various indications in daily clinical practice in Switzerland.METHODS:This prospective,consecutive case series was conducted at a tertiary care hospital from September 2010 to January 2014.Indications for OTSC application were fistulae,anastomotic leakage,perforation,unroofed submucosal lesion for biopsy,refractory bleeding,and stent fixation in the gastrointestinal(GI)tract.Primary technical success was defined as the adequate deployment of the OTSC on the target lesion.Clinical success was defined as resolution of the problem;for instance,no requirement for surgery or further endoscopic intervention.In cases of recurrence,retreatment of a lesion with a second intervention was possible.Complications were classified into those related to sedation,endoscopy,or deployment of the clip.RESULTS:A total of 28 OTSC system applications werecarried out in 21 patients[median age 64 years(range42-85),33%females].The main indications were fistulae(52%),mostly after percutaneous endoscopic gastrostomy tube removal,and anastomotic leakage after GI surgery(29%).Further indications were unroofed submucosal lesions after biopsy,upper gastrointestinal bleeding,or esophageal stent fixation.The OTSC treatments were applied either in the upper(48%)or lower(52%)GI tract.The mean lesion size was 8 mm(range:2-20 mm).Primary technical success and clinical success rates were 85%and 67%,respectively.In53%of cases,the suction method was used without accessories(e.g.,twin grasper or tissue anchor).No endoscopy-related or OTSC-related complications were observed.CONCLUSION:OTSC is a useful tool for endoscopic closure of various GI lesions,including fistulae and leakages.Future randomized prospective multicenter trials are warranted.
文摘Percutaneous endoscopic gastrostomy(PEG) is a common practice for long-term nutrition of patients who are unable to take oral food. We report of an 85-year old man with a history of recurrent larynx carcinoma and hemicolectomy many years ago due to unknown reason. Laryngectomy was indicated. Preoperatively a PEG was inserted endoscopically after an abdominal ultrasonography without abnormal findings. Few months after PEG insertion, the patient was evaluated for diarrhea and insufficient feeding without signs of infection or peritonism. An upper endoscopy and computed tomography scan confirmed a buried bumper syndrome with migration of the PEG tube into the colon as a rare complication. He underwent successful colonoscopic removal of the internal bumper and closure of the colonic orifice of the fistula with the over-the-scope-clip system(OTSC). OTSC is an endoscopic device for treatment of bleeding, perforation, leak and fistula in the gastrointestinal tract. To the best of our knowledge, this is the first report of the use of OTSC for colonoscopic closure of a gastrocolocutaneous fistula due to a buried bumper syndrome with transcolonic PEG tube migration.
基金Supported the Project for Revision of Overall Land Use Plan for Dafang County(Guizhou University[2009]HT1226)Construction of Graphics Library for Dafang County([2011]1201)
文摘At the township level,combining Voronoi diagram and breaking point theory,this paper divides township grade system and its scope of influence in Dafang County of Guizhou Province,and discusses the grade system from small scale perspective.Results show that Dafang County takes Dafang Town as the center,Dashi Town in the north and Shachang Township in the east as auxiliary part,Sanyuan Township,Zhuyuan Township,Babao Township,Pudi Township,Lihua Township,and Dingxin Township as cooperative part,to drive development of 36 townships in Dafang County.Thus,it basically reflects township grade of Dafang County,accords with current development situation,provides certain reference value for system planning and economic zoning of small scale regions,and it is able to improve the accuracy of scope division by completing attribute data and revision of many methods.
文摘AIM: To compare the new Olympus V-scope (VS) to conventional endoscopic retrograde cholangiopancreati-cography (ERCP). METHODS: Forty-nine patients with previous endoscopic papillotomy who were admitted for interventional ERCP for one of several reasons were included in this single-centre, prospective randomized study. Consecutive patients were randomized to either the VS group or to the conventional ERCP group. ERCP-nave patients who had not undergone papillotomy were excluded. The main study parameters were interventional examination time, X-ray time and dose, and premedication dose (all given below as the median, range) and were investigated in addition to each patient's clinical outcome and complications. Subjective scores to assess each procedure were also provided by the physicians and endoscopy assistants who carried out the procedures. A statistical analysis was carried out using the Wilcoxon rank-sum test.RESULTS: Twenty-five patients with 50 interventions were examined with the VS ERCP technique, and 24 patients with 47 interventions were examined using the conventional ERCP technique. There were no significant differences between the two groups regarding the age, sex, indications, degree of ERCP difficulty, or interventions performed. The main study parameters in the VS group showed a nonsignificant trend towards a shorter interventional examination time (29 min, 5-50 min vs 31 min, 7-90 min, P = 0.28), shorter X-ray time (5.8 min, 0.6-14.1 min vs 6.1 min, 1.6-18.8 min, P = 0.48), and lower X-ray dose (1351 cGy/m2 , 159-5039 cGy/m2 vs 1296 cGy/m2 , 202.2-6421 cGy/m 2 , P = 0.34). A nonsignificant trend towards fewer adverse events occurred in the VS group as compared with the conventional ERCP group (cholangitis: 12% vs 16%, P = 0.12; pain: 4% vs 12.5%, P = 0.33; post-ERCP pancreatitis: 4% vs 12.5%, P = 0.14). In addition, there were no statistically significant differences in assessment by the physicians and endoscopy assistants using subjective questionnaires.CONCLUSION: ERCP using the short-guidewire V-system did not significantly improve ERCP performance or patient outcomes, but it may reduce and simplify the ERCP procedure in difficult settings.
文摘目的:系统检索并筛选国内外健康服务领域膳食推荐系统相关的文献,梳理、汇总与分析膳食推荐系统的特征、算法及应用场景,为推动膳食推荐系统助力个性化营养提供依据。方法:使用主题词和自由词检索方式在中英文数据库中进行文献检索,检索时限为数据库建库至2024年3月31日,依据Arksey and O′Malley范围综述方法学框架及Joanna Briggs Institute(JBI)证据整合手册,对纳入文献进行信息提取、汇总和分析。结果:共纳入38篇文献。5项研究针对慢性病病人或糖尿病病人进行膳食推荐,其余研究并未明确推荐人群;23项研究的推荐产品为菜谱,6项研究为食材推荐,3项研究为菜品套餐推荐;4项研究为三餐规划推荐;1项研究为食疗处方推荐,另有1项研究为零食推荐。31篇文献采用离线实验进行系统测试,10篇文献采用用户调查进行测试,1篇文献进行了预试验,1篇进行了在线实验测试。结论:推荐系统算法模型的发展从理论层面证明其推荐功能的可实现性,但相关研究仍处于起步阶段,相关报告不完善,评估体系尚未健全,未来膳食推荐系统应通过实践应用对其可用性和效果进行评价,促进膳食推荐系统赋能营养健康,助力膳食管理。
