Objective:To explore the clinical value of a three-subject,dual-track interactive nursing model based on smart nursing in patients with intestinal polyps.Methods:From July 2024 to February 2025,200 patients with intes...Objective:To explore the clinical value of a three-subject,dual-track interactive nursing model based on smart nursing in patients with intestinal polyps.Methods:From July 2024 to February 2025,200 patients with intestinal polyps admitted to our hospital were selected and divided into a control group and an observation group,with 100 patients in each group,based on different nursing methods.The control group received routine nursing,while the observation group received a three-subject,dual-track interactive nursing model based on smart nursing.The nursing effects of the two groups were compared and analyzed.Results:The first defecation time in the observation group was shorter than that in the control group(p<0.05).After nursing,the ESCA score,CSES score,scores for the right colon,transverse colon,left colon,total BBPS score,intestinal preparation qualification rate,and nursing satisfaction in the observation group were all higher than those in the control group(p<0.05).Conclusion:The application of a three-subject,dual-track interactive nursing model based on smart nursing in patients with intestinal polyps can effectively alleviate gastrointestinal function,improve self-care ability,and enhance nursing satisfaction.展开更多
BACKGROUND Implementing nursing interventions in patients undergoing endoscopic treatment for intestinal polyps and early stage cancer can serve as a reference for reducing the incidence of complications,accelerating ...BACKGROUND Implementing nursing interventions in patients undergoing endoscopic treatment for intestinal polyps and early stage cancer can serve as a reference for reducing the incidence of complications,accelerating the recovery process,and improving the quality of life.AIM To impact of systematic nursing intervention on recovery,complications prevention,and quality of life after endoscopic surgery for intestinal polyps.METHODS This retrospective study included 157 patients who underwent endoscopic mucosal resection or endoscopic submucosal dissection at our hospital.The patients were divided into intervention and conventional groups,with no significant differences in age,sex,or surgical methods.The intervention group received multidimensional nursing interventions,including preoperative evaluation,intraoperative cooperation,postoperative rehabilitation,psychological support and nutritional management.The conventional group received standardized care.Clinical efficacy,inflammation and infection indicators,complication rates,rehabilitation indicators,and visual analog scale(VAS)scores were compared.RESULTS On the 7th day after surgery,C-reactive protein(CRP)and white blood cell levels were lower in the intervention group than in the conventional group.Complications occurred in 9.33%of the patients in the intervention group and 23.17%in the conventional group,with significant differences in fever and abdominal distension.The intervention group had shorter first exhaust and hospitalization durations than the control group.By day 3 post-surgery,the intervention group showed lower VAS scores and reduced anxiety and depression.High-risk factors included diabetes[relative risk(RR)=2.43,95%CI:1.21-4.86],laparotomy(RR=2.86,95%CI:1.22-6.71),CRP>15 mg/L(RR=3.12,95%CI:1.54-6.33),and procalcitonin>0.5 ng/mL 1 day after surgery(RR=2.91.95%CI:1.31-6.44),while systematic nursing interventions(OR=0.40,95%CI:0.18-0.89)reduced the complication risk by 60%.CONCLUSION Multidimensional nursing interventions have clinical value in endoscopic treatment of intestinal polyps and early stage cancer,reducing complications and hospital stay.This study provides a basis for establishing patientcentered guidelines.展开更多
AIM: To clarify the molecular mechanism involved in pathogenesis of colorectal cancer as well as clinical significance of genetic analysis of histological samples.
This editorial,inspired by a recent study published in the World Journal of Gastrointestinal Oncology,covers the research findings on microbiota changes in various diseases.In recurrent colorectal polyps,the abundance...This editorial,inspired by a recent study published in the World Journal of Gastrointestinal Oncology,covers the research findings on microbiota changes in various diseases.In recurrent colorectal polyps,the abundances of Klebsiella,Parvimonas,and Clostridium increase,while those of Bifidobacterium and Lactoba-cillus decrease.This dysbiosis may promote the formation and recurrence of polyps.Similar microbial changes have also been observed in colorectal cancer,inflammatory bowel disease,autism spectrum disorder,and metabolic syndrome,indicating the role of increased pathogens and decreased probiotics in these conditions.Regulating the gut microbiota,particularly by increasing probiotic levels,may help prevent polyp recurrence and promote gut health.This microbial intervention strategy holds promise as an adjunctive treatment for patients with colorectal polyps.展开更多
OBJECTIVE:To explore the relationship between colorectal polyps and pulmonary nodules from the perspective of the lung and the large intestine being internally and externally connected,aiming to provide a theoretical ...OBJECTIVE:To explore the relationship between colorectal polyps and pulmonary nodules from the perspective of the lung and the large intestine being internally and externally connected,aiming to provide a theoretical basis for clinical diagnosis and treatment.METHODS:We retrospectively analyzed the data of patients who underwent electronic colonoscopy and were found to have colorectal polyps at the Gastrointestinal Endoscopy Center of Dongfang Hospital,Beijing University of Chinese Medicine,from January 1,2017,to December 31,2023.We also reviewed their lung CT results and used statistical software to analyze the recurrence,location,size,and pathology of colorectal polyps in relation to the presence,number,and size of pulmonary nodules.RESULTS:Both colorectal polyps and pulmonary nodules are more common in elderly males.Patients with recurrent colorectal polyps are more likely to have pulmonary nodules,which tend to be located in the left colon and are more likely to be adenomatous in nature;those without pulmonary nodules show no clear pattern in polyp distribution,with a tendency towards inflammatory and hyperplastic pathology;the data from this study suggests that the proportion of lung nodules larger than 0.5 cm in the recurrent group is higher than in the non-recurrent group,and the proportion of colorectal polyps larger than 1 cm in the recurrent group is also higher than in the non-recurrent group.CONCLUSION:There is a certain connection between the pathogenesis and treatment of colorectal polyps and pulmonary nodules.Cold,phlegm,dampness,blood stasis,and toxic coagulation are common pathogenic factors of the two diseases.Patients with larger colorectal polyps should be advised to undergo regular colonoscopy.Patients with recurrent polyps or those with left colon necrosis or cancer indicated by colonoscopy should be advised to complete lung related examinations to rule out the possibility of pulmonary nodules.展开更多
AIM:To detect the prevalence of small bowel polyps by wireless capsule endoscopy(WCE)in patients with familial adenomatous polyposis(FAP).METHODS:We examined prospectively 14 patients with FAP to assess the location,s...AIM:To detect the prevalence of small bowel polyps by wireless capsule endoscopy(WCE)in patients with familial adenomatous polyposis(FAP).METHODS:We examined prospectively 14 patients with FAP to assess the location,size and number of small-intestinal polyps.Patients'age,sex,years of observation after surgery,type of surgery,duodenal polyps and colorectal cancer at surgery were analyzed.RESULTS:During WCE,polyps were detected in 9/14(64.3%)patients.Duodenal adenomatous polyps were found in nine(64.3%)patients,and jejunal and ileal polyps in seven(50%)and eight(57.1%),respectively.The Spigelman stage of duodenal polyposis was associated with the presence of jejunal and ileal polyps.Identification of the ampulla of Vater was not achieved with WCE.Importantly,the findings of WCE had no immediate impact on the further clinical management of FAP patients.No procedure-related complications were observed in the patients.CONCLUSION:WCE is a promising noninvasive new method for the detection of small-intestinal polyps.Further investigation is required to determine which phenotype of FAP is needed for surveillance with WCE.展开更多
Background:The interrelation between intestinal polyps,metabolic syndrome(MetS),and colorectal cancer(CRC)is a critical area of study.This research focuses on pinpointing potential molecular targets to understand the ...Background:The interrelation between intestinal polyps,metabolic syndrome(MetS),and colorectal cancer(CRC)is a critical area of study.This research focuses on pinpointing potential molecular targets to understand the link between intestinal polyp formation,metabolic irregularities,and CRC progression.Methods:We examined clinical samples from patients with intestinal polyps coexisting with MetS and compared them with samples from patients with standard intestinal polyps.Transcriptome sequencing and public database analysis were employed to identify significant pathways and genes.These targets were then validated through immunohistochemistry(IHC).Following the RNA interference of key target expression,a series of experiments,including the cell counting kit-8 assay,colony formation,wound healing,and Transwell assays,were conducted.Results:Comparative analysis revealed 75 up-regulated and 61 down-regulated differentially expressed genes(DEGs)in the MetS polyp group vs.the control.Kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment suggested these DEGs were primarily associated with cell cycle and mitosis.Integration with comparative toxicogenomics database(CTD)and the cancer genome atlas(TCGA)databases highlighted 44 key CRC-related genes.Protein interaction networks indicated connections of purkinje cell protein 4(PCP4),olfactomedin 1(OLFM1),fibronectin 1(FN1),and transforming growth factor beta 3(TGF-β3)with the mitogen-activated protein kinase(MAPK)pathway.Tumor correlation studies suggested higher risk associations with FN1,PCP4,and TGF-β3,while OLFM1 was identified as a lower risk gene.Immunohistochemical analysis revealed a decrease in OLFM1 in MetS-associated intestinal polyps.Upon interference with OLFM1 in polyp epithelial cells,there was a significant enhancement in cell proliferation,colony formation,and cell migration and invasion capabilities.Conclusion:Our study highlights a significant decrease in OLFM1 expression in MetS-associated intestinal polyps.And,this reduction in OLFM1 is associated with enhanced cell proliferation,colony formation,and increased cell migration and invasion capabilities.These findings underscore the reduced OLFM1 expression in MetS-associated intestinal polyps may play a crucial role in promoting tumorigenic processes in colorectal pathology.Further research on OLFM1 may provide valuable insights into understanding and targeting MetS-associated intestinal polyps.展开更多
Objective: this study mainly studies the treatment of patients with intestinal polyps, and conducts the treatment process under the control of gastrointestinal endoscopy, in order to improve the treatment effect of th...Objective: this study mainly studies the treatment of patients with intestinal polyps, and conducts the treatment process under the control of gastrointestinal endoscopy, in order to improve the treatment effect of these patients, shorten the treatment time and recovery time of the patients, and improve the life of the patients. quality. Methods: This study selected 72 patients with intestinal polyps who came to our hospital from November 2020 to January 2022. All patients received intestinal polyp treatment as part of gastrointestinal endoscopy. In order to observe the research results, the selected patients were compared and examined in order to better observe the research results. During the examination of all selected patients, the nursing effect and the occurrence of adverse events should be carefully recorded and compared. At the same time, before nursing the selected patients, professional medical staff will evaluate the overall condition of the patients to ensure that the patients can cooperate in the process of this study, and then they can be included in the study. Patients should also take the initiative to inform patients of the research content and purpose, and the research results can be published only with the consent of patients. Results: two different nursing methods had different effects on selected patients, but relatively high-quality nursing methods were preferred by patients, which minimized adverse reactions during the patient's recovery. There were differences in the results across all patients, which better support the data from this study.展开更多
Since the first report of use of endoscopy in children in the 1970 s, there has seen an exponential growthin published experience and innovation in the field. In this review article we focus on modern age therapeutic ...Since the first report of use of endoscopy in children in the 1970 s, there has seen an exponential growthin published experience and innovation in the field. In this review article we focus on modern age therapeutic endoscopy practice, explaining use of traditional as well as new and innovative techniques, for diagnosis and treatment of diseases in the paediatric upper gastrointestinal tract.展开更多
AIM:Hypertrophied anal papillae and fibrous anal polyps are not given due importance in the proctology practice. They are mostly ignored being considered as normal structures.The present study was aimed to demonstrate...AIM:Hypertrophied anal papillae and fibrous anal polyps are not given due importance in the proctology practice. They are mostly ignored being considered as normal structures.The present study was aimed to demonstrate that hypertrophied anal papillae and fibrous anal polyps could cause symptoms to the patients and that they should be removed in treatment of patients with chronic fissure in anus. METHODS:Two groups of patients were studied.A hundred patients were studied in group A in which the associated fibrous polyp or papillae were removed by radio frequency surgical device after a lateral subcutaneous sphincterotomy for relieving the sphincter spasm.Another group of a hundred patients who also had papillae or fibrous polyps,were treated by lateral sphincterotomy alone.They were followed up for one year. RESULTS:Eighty-nine percent patients from group A expressed their satisfaction with the treatment in comparison to only 64% from group B who underwent sphincterotomy alone with the papillae or anal polyps left untreated.Group A patients showed a marked reduction with regard to pain and irritation during defecation (P=0.0011), pricking or foreign body sensation in the anus (P=0.0006) and pruritus or wetness around the anal verge (P=0.0008). CONCLUSION:Hypertrophied anal papillae and fibrous anal polyps should be removed during treatment of chronic anal fissure.This would add to effectiveness and completeness of the procedure.展开更多
BACKGROUND While colorectal polyps are not cancerous,some types of polyps,known as adenomas,can develop into colorectal cancer over time.Polyps can often be found and removed by colonoscopy;however,this is an invasive...BACKGROUND While colorectal polyps are not cancerous,some types of polyps,known as adenomas,can develop into colorectal cancer over time.Polyps can often be found and removed by colonoscopy;however,this is an invasive and expensive test.Thus,there is a need for new methods of screening patients at high risk of developing polyps.AIM To identify a potential association between colorectal polyps and small intestine bacteria overgrowth(SIBO)or other relevant factors in a patient cohort with lactulose breath test(LBT)results.METHODS A total of 382 patients who had received an LBT were classified into polyp and non-polyp groups that were confirmed by colonoscopy and pathology.SIBO was diagnosed by measuring LBTderived hydrogen(H)and methane(M)levels according to 2017 North American Consensus recommendations.Logistic regression was used to assess the ability of LBT to predict colorectal polyps.Intestinal barrier function damage(IBFD)was determined by blood assays.RESULTS H and M levels revealed that the prevalence of SIBO was significantly higher in the polyp group than in the non-polyp group(41%vs 23%,P<0.01;71%vs 59%,P<0.05,respectively).Within 90 min of lactulose ingestion,the peak H values in the adenomatous and inflammatory/hyperplastic polyp patients were significantly higher than those in the non-polyp group(P<0.01,and P=0.03,respectively).In 227 patients with SIBO defined by combining H and M values,the rate of IBFD determined by blood lipopolysaccharide levels was significantly higher among patients with polyps than those without(15%vs 5%,P<0.05).In regression analysis with age and gender adjustment,colorectal polyps were most accurately predicted with models using M peak values or combined H and M values limited by North American Consensus recommendations for SIBO.These models had a sensitivity of≥0.67,a specificity of≥0.64,and an accuracy of≥0.66.CONCLUSION The current study made key associations among colorectal polyps,SIBO,and IBFD and demonstrated that LBT has moderate potential as an alternative noninvasive screening tool for colorectal polyps.展开更多
BACKGROUND Colorectal cancer(CRC)is the third most common cancer worldwide,with the fourth highest mortality among all cancers.Reportedly,in addition to adenomas,serrated polyps,which account for 15%-30%of CRCs,can al...BACKGROUND Colorectal cancer(CRC)is the third most common cancer worldwide,with the fourth highest mortality among all cancers.Reportedly,in addition to adenomas,serrated polyps,which account for 15%-30%of CRCs,can also develop into CRCs through the serrated pathway.Sessile serrated adenomas/polyps(SSAs/Ps),a type of serrated polyps,are easily misdiagnosed during endoscopy.AIM To observe the difference in the Wnt signaling pathway expression in SSAs/Ps patients with different syndrome types.METHODS From January 2021 to December 2021,patients with SSAs/Ps were recruited from the Endoscopy Room of Shanghai Traditional Chinese Medicine-Integrated Hospital,affiliated with Shanghai University of Traditional Chinese Medicine.Thirty cases each of large intestine damp-heat(Da-Chang-Shi-Re,DCSR)syndrome and spleen-stomach weakness(Pi-Wei-Xu-Ruo)syndrome were reported.Baseline comparison of the general data,typical tongue coating,colonoscopy findings,and hematoxylin and eosin findings was performed in each group.The expression of the Wnt pathway-related proteins,namelyβ-catenin,adenomatous polyposis coli,and mutated in colorectal cancer,were analyzed using immunohistochemistry.RESULTS Significant differences were observed with respect to the SSAs/Ps size between the two groups of patients with different syndrome types(P=0.001).The other aspects did not differ between the two groups.The Wnt signaling pathway was activated in patients with SSAs/Ps belonging to both groups,which was manifested asβ-catenin protein translocation into the nucleus.However,SSAs/Ps patients with DCSR syndrome had more nucleation,higherβ-catenin expression,and negative regulatory factor(adenomatous polyposis coli and mutated in colorectal cancer)expression(P<0.0001)than SSA/P patients with Pi-Wei-Xu-Ruo syndrome.In addition,the SSA/P size was linearly correlated with the related protein expression.CONCLUSION Patients with DCSR syndrome had a more obvious Wnt signaling pathway activation and a higher risk of carcinogenesis.A high-quality colonoscopic diagnosis was essential.The thorough assessment of clinical diseases can be improved by combining the diseases of Western medicine with the syndromes of traditional Chinese medicine.展开更多
BACKGROUND Gastric Helicobacter pylori(H.pylori)infection is related to chronic gastritis,gastroduodenal ulcer,and gastric malignancies;whether this infection is related to colorectal polyps and colorectal cancer(CRC)...BACKGROUND Gastric Helicobacter pylori(H.pylori)infection is related to chronic gastritis,gastroduodenal ulcer,and gastric malignancies;whether this infection is related to colorectal polyps and colorectal cancer(CRC),remains debatable.AIM To investigate the relationship between gastric H.pylori infection and the risk of colorectal polyps and CRC.METHODS We retrospectively analyzed 3872 patients with colorectal polyps who underwent colonoscopy and pathological diagnosis.We also analyzed 304 patients with primary CRC.The characteristics of these patients were compared with those of the control group,which included 2362 patients with the normal intestinal mucosa.All subjects completed a 14C-urea breath test,bidirectional gastrointestinal endoscopy,and a biopsy on the same day.Data on the number,size,location,and pathology of the polyps,the location,and pathology of the CRC,the detection of H.pylori,and the incidence of H.pylori-associated atrophic gastritis or intestinal metaplasia were obtained.A logistic regression model was used to analyze the relationship between gastric infection due to H.pylori,and the incidence of colorectal polyps and CRC.RESULTS The prevalence of H.pylori infection was higher in the multiple polyps group than in the solitary polyp group and the control group[95%confidence interval(CI)=1.02-1.31,P=0.03;95%CI:2.12-2.74,P<0.001].The patients with adenomatous polyps had a higher incidence of H.pylori infection than patients with non-adenomatous polyps[59.95%vs 51.75%,adjusted odds ratio(OR)=1.41,95%CI:1.24-1.60,P<0.01].Patients with H.pylori-associated atrophic gastritis or intestinal metaplasia were at high risk of CRC(adjusted OR=3.46,95%CI:2.63-4.55,P<0.01;adjusted OR=4.86,95%CI:3.22-7.34,P<0.01,respectively).The size and location of the polyps,the histopathological characteristics and the location of CRC were not related to H.pylori infection.CONCLUSION Our study demonstrates that the incidence of gastric H.pylori infection and H.pylori-associated atrophic gastritis or intestinal metaplasia elevates the risk of colorectal polyps and CRC.展开更多
AIM: To present our initial experience regarding the feasibility of ultrasound virtual endoscopy(USVE) and its measurement reliability for polyp detection in an in vitro study using pig intestine specimens.METHODS: Si...AIM: To present our initial experience regarding the feasibility of ultrasound virtual endoscopy(USVE) and its measurement reliability for polyp detection in an in vitro study using pig intestine specimens.METHODS: Six porcine intestine specimens containing 30 synthetic polyps underwent USVE, computed tomography colonography(CTC) and optical colonoscopy(OC) for polyp detection. The polyp measurement defined as the maximum polyp diameter on twodimensional(2D) multiplanar reformatted(MPR) planes was obtained by USVE, and the absolute measurement error was analyzed using the direct measurement as the reference standard.RESULTS: USVE detected 29(96.7%) of 30 polyps, remaining a 7-mm one missed. There was one falsepositive finding. Twenty-six(89.7%) of 29 reconstructedimages were clearly depicted, while 29(96.7%) of 30 polyps were displayed on CTC with one false-negative finding. In OC, all the polyps were detected. The intraclass correlation coefficient was 0.876(95%CI: 0.745-0.940) for measurements obtained with USVE. The pooled absolute measurement errors ± the standard deviations of the depicted polyps with actual sizes ≤ 5 mm, 6-9 mm, and ≥ 10 mm were 1.9 ± 0.8 mm, 0.9 ± 1.2 mm, and 1.0 ± 1.4 mm, respectively.CONCLUSION: USVE is reliable for polyp detection and measurement in in vitro study.展开更多
BACKGROUND Although substantial evidence supports the advantages of cold snare polypectomy(CSP)in terms of polypectomy efficacy and reduced postoperative adverse events,few studies have examined the cost differences b...BACKGROUND Although substantial evidence supports the advantages of cold snare polypectomy(CSP)in terms of polypectomy efficacy and reduced postoperative adverse events,few studies have examined the cost differences between CSP and traditional endoscopic mucosal resection(EMR)for the treatment of intestinal polyps.AIM To compare the efficacy-cost of EMR and CSP in the treatment of intestinal polyps.METHODS A total of 100 patients with intestinal polyps were included in the retrospective data of our hospital from April 2022 to May 2023.According to the treatment methods,they were divided into EMR(n=46)group and CSP(n=54)group.The baseline data of the two groups were balanced by 1:1 propensity score matching(PSM),and the cost-effectiveness analysis was performed on the two groups after matching.The recurrence rate of the two groups of patients was followed up for 1 year,and they were divided into recurrence group and non-recurrence group according to whether they recurred.Multivariate logistic regression analysis was used to screen out the influencing factors affecting the recurrence of intestinal polyps after endoscopic resection.RESULTS Significant disparities were observed in the number of polyps and smoking background between the two groups before PSM(P<0.05).Following PSM,the number of polyps and smoking history were well balanced between the EMR and CSP groups.The direct cost incurred by the CSP group was markedly higher than that incurred by the EMR group.Concurrently,the cost-effectiveness ratio in the CSP group was substantially reduced when juxtaposed with that in the EMR group(P<0.05).Upon completion of the 1-year follow-up,the rate of recurrence after endoscopic intestinal polypectomy was 38.00%.Multivariate methods revealed that age≥60 years,male sex,number of polyps≥3,and pathological type of adenoma were risk factors for recurrence after endoscopic intestinal polypectomy(all P<0.05).CONCLUSION CSP was more cost-effective for the treatment of intestinal polyps.An age≥60 years,male sex,having a number of polyps≥3,and pathological type of adenoma are independent influencing factors for recurrence.展开更多
AIM:To investigate biological prevention with flavonoids the recurrence risk of neoplasia was studied in patients with resected colorectal cancer and after adenoma polypectomy.METHODS:Eighty-seven patients,36 patients...AIM:To investigate biological prevention with flavonoids the recurrence risk of neoplasia was studied in patients with resected colorectal cancer and after adenoma polypectomy.METHODS:Eighty-seven patients,36 patients with resected colon cancer and 51 patients after polypectomy,were divided into 2 groups:one group was treated with a flavonoid mixture(daily standard dose 20 mg apigenin and 20 mg epigallocathechin-gallat,n=31)and compared with a matched control group(n=56).Both groups were observed for 3-4 years by surveillance colonoscopy and by questionnaire.RESULTS:Of 87 patients enrolled in this study,36 had resected colon cancer and 29 of these patients had surveillance colonoscopy.Among the flavonoid-treated patients with resected colon cancer(n=14),there was no cancer recurrence and one adenoma developed.In contrast the cancer recurrence rate of the 15 matched untreated controls was 20%(3 of 15)and adenomas evolved in 4 of those patients(27%).The combined recurrence rate for neoplasia was 7%(1 of 14)in the treated patients and 47%(7 of 15)in the controls(P=0.027).CONCLUSION:Sustained long-term treatment with a flavonoid mixture could reduce the recurrence rate of colon neoplasia in patients with resected colon cancer.展开更多
文摘Objective:To explore the clinical value of a three-subject,dual-track interactive nursing model based on smart nursing in patients with intestinal polyps.Methods:From July 2024 to February 2025,200 patients with intestinal polyps admitted to our hospital were selected and divided into a control group and an observation group,with 100 patients in each group,based on different nursing methods.The control group received routine nursing,while the observation group received a three-subject,dual-track interactive nursing model based on smart nursing.The nursing effects of the two groups were compared and analyzed.Results:The first defecation time in the observation group was shorter than that in the control group(p<0.05).After nursing,the ESCA score,CSES score,scores for the right colon,transverse colon,left colon,total BBPS score,intestinal preparation qualification rate,and nursing satisfaction in the observation group were all higher than those in the control group(p<0.05).Conclusion:The application of a three-subject,dual-track interactive nursing model based on smart nursing in patients with intestinal polyps can effectively alleviate gastrointestinal function,improve self-care ability,and enhance nursing satisfaction.
文摘BACKGROUND Implementing nursing interventions in patients undergoing endoscopic treatment for intestinal polyps and early stage cancer can serve as a reference for reducing the incidence of complications,accelerating the recovery process,and improving the quality of life.AIM To impact of systematic nursing intervention on recovery,complications prevention,and quality of life after endoscopic surgery for intestinal polyps.METHODS This retrospective study included 157 patients who underwent endoscopic mucosal resection or endoscopic submucosal dissection at our hospital.The patients were divided into intervention and conventional groups,with no significant differences in age,sex,or surgical methods.The intervention group received multidimensional nursing interventions,including preoperative evaluation,intraoperative cooperation,postoperative rehabilitation,psychological support and nutritional management.The conventional group received standardized care.Clinical efficacy,inflammation and infection indicators,complication rates,rehabilitation indicators,and visual analog scale(VAS)scores were compared.RESULTS On the 7th day after surgery,C-reactive protein(CRP)and white blood cell levels were lower in the intervention group than in the conventional group.Complications occurred in 9.33%of the patients in the intervention group and 23.17%in the conventional group,with significant differences in fever and abdominal distension.The intervention group had shorter first exhaust and hospitalization durations than the control group.By day 3 post-surgery,the intervention group showed lower VAS scores and reduced anxiety and depression.High-risk factors included diabetes[relative risk(RR)=2.43,95%CI:1.21-4.86],laparotomy(RR=2.86,95%CI:1.22-6.71),CRP>15 mg/L(RR=3.12,95%CI:1.54-6.33),and procalcitonin>0.5 ng/mL 1 day after surgery(RR=2.91.95%CI:1.31-6.44),while systematic nursing interventions(OR=0.40,95%CI:0.18-0.89)reduced the complication risk by 60%.CONCLUSION Multidimensional nursing interventions have clinical value in endoscopic treatment of intestinal polyps and early stage cancer,reducing complications and hospital stay.This study provides a basis for establishing patientcentered guidelines.
基金Supported by Capital Public Health Project Cultivation Program,No.Z111107067311051
文摘AIM: To clarify the molecular mechanism involved in pathogenesis of colorectal cancer as well as clinical significance of genetic analysis of histological samples.
文摘This editorial,inspired by a recent study published in the World Journal of Gastrointestinal Oncology,covers the research findings on microbiota changes in various diseases.In recurrent colorectal polyps,the abundances of Klebsiella,Parvimonas,and Clostridium increase,while those of Bifidobacterium and Lactoba-cillus decrease.This dysbiosis may promote the formation and recurrence of polyps.Similar microbial changes have also been observed in colorectal cancer,inflammatory bowel disease,autism spectrum disorder,and metabolic syndrome,indicating the role of increased pathogens and decreased probiotics in these conditions.Regulating the gut microbiota,particularly by increasing probiotic levels,may help prevent polyp recurrence and promote gut health.This microbial intervention strategy holds promise as an adjunctive treatment for patients with colorectal polyps.
基金Beijing Natural Science Foundation:Research on the Mechanism of Chaiqi Decoction in Improving Vascular Endothelial Injury in Metabolic Syndrome by Regulating Pyroptosis via miR-21(No.7212181)。
文摘OBJECTIVE:To explore the relationship between colorectal polyps and pulmonary nodules from the perspective of the lung and the large intestine being internally and externally connected,aiming to provide a theoretical basis for clinical diagnosis and treatment.METHODS:We retrospectively analyzed the data of patients who underwent electronic colonoscopy and were found to have colorectal polyps at the Gastrointestinal Endoscopy Center of Dongfang Hospital,Beijing University of Chinese Medicine,from January 1,2017,to December 31,2023.We also reviewed their lung CT results and used statistical software to analyze the recurrence,location,size,and pathology of colorectal polyps in relation to the presence,number,and size of pulmonary nodules.RESULTS:Both colorectal polyps and pulmonary nodules are more common in elderly males.Patients with recurrent colorectal polyps are more likely to have pulmonary nodules,which tend to be located in the left colon and are more likely to be adenomatous in nature;those without pulmonary nodules show no clear pattern in polyp distribution,with a tendency towards inflammatory and hyperplastic pathology;the data from this study suggests that the proportion of lung nodules larger than 0.5 cm in the recurrent group is higher than in the non-recurrent group,and the proportion of colorectal polyps larger than 1 cm in the recurrent group is also higher than in the non-recurrent group.CONCLUSION:There is a certain connection between the pathogenesis and treatment of colorectal polyps and pulmonary nodules.Cold,phlegm,dampness,blood stasis,and toxic coagulation are common pathogenic factors of the two diseases.Patients with larger colorectal polyps should be advised to undergo regular colonoscopy.Patients with recurrent polyps or those with left colon necrosis or cancer indicated by colonoscopy should be advised to complete lung related examinations to rule out the possibility of pulmonary nodules.
文摘AIM:To detect the prevalence of small bowel polyps by wireless capsule endoscopy(WCE)in patients with familial adenomatous polyposis(FAP).METHODS:We examined prospectively 14 patients with FAP to assess the location,size and number of small-intestinal polyps.Patients'age,sex,years of observation after surgery,type of surgery,duodenal polyps and colorectal cancer at surgery were analyzed.RESULTS:During WCE,polyps were detected in 9/14(64.3%)patients.Duodenal adenomatous polyps were found in nine(64.3%)patients,and jejunal and ileal polyps in seven(50%)and eight(57.1%),respectively.The Spigelman stage of duodenal polyposis was associated with the presence of jejunal and ileal polyps.Identification of the ampulla of Vater was not achieved with WCE.Importantly,the findings of WCE had no immediate impact on the further clinical management of FAP patients.No procedure-related complications were observed in the patients.CONCLUSION:WCE is a promising noninvasive new method for the detection of small-intestinal polyps.Further investigation is required to determine which phenotype of FAP is needed for surveillance with WCE.
基金This work was supported by Hospital Incubation Fund of the First Affiliated Hospital of Chongqing Medical and Pharmaceutical College(No.201704).
文摘Background:The interrelation between intestinal polyps,metabolic syndrome(MetS),and colorectal cancer(CRC)is a critical area of study.This research focuses on pinpointing potential molecular targets to understand the link between intestinal polyp formation,metabolic irregularities,and CRC progression.Methods:We examined clinical samples from patients with intestinal polyps coexisting with MetS and compared them with samples from patients with standard intestinal polyps.Transcriptome sequencing and public database analysis were employed to identify significant pathways and genes.These targets were then validated through immunohistochemistry(IHC).Following the RNA interference of key target expression,a series of experiments,including the cell counting kit-8 assay,colony formation,wound healing,and Transwell assays,were conducted.Results:Comparative analysis revealed 75 up-regulated and 61 down-regulated differentially expressed genes(DEGs)in the MetS polyp group vs.the control.Kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment suggested these DEGs were primarily associated with cell cycle and mitosis.Integration with comparative toxicogenomics database(CTD)and the cancer genome atlas(TCGA)databases highlighted 44 key CRC-related genes.Protein interaction networks indicated connections of purkinje cell protein 4(PCP4),olfactomedin 1(OLFM1),fibronectin 1(FN1),and transforming growth factor beta 3(TGF-β3)with the mitogen-activated protein kinase(MAPK)pathway.Tumor correlation studies suggested higher risk associations with FN1,PCP4,and TGF-β3,while OLFM1 was identified as a lower risk gene.Immunohistochemical analysis revealed a decrease in OLFM1 in MetS-associated intestinal polyps.Upon interference with OLFM1 in polyp epithelial cells,there was a significant enhancement in cell proliferation,colony formation,and cell migration and invasion capabilities.Conclusion:Our study highlights a significant decrease in OLFM1 expression in MetS-associated intestinal polyps.And,this reduction in OLFM1 is associated with enhanced cell proliferation,colony formation,and increased cell migration and invasion capabilities.These findings underscore the reduced OLFM1 expression in MetS-associated intestinal polyps may play a crucial role in promoting tumorigenic processes in colorectal pathology.Further research on OLFM1 may provide valuable insights into understanding and targeting MetS-associated intestinal polyps.
文摘Objective: this study mainly studies the treatment of patients with intestinal polyps, and conducts the treatment process under the control of gastrointestinal endoscopy, in order to improve the treatment effect of these patients, shorten the treatment time and recovery time of the patients, and improve the life of the patients. quality. Methods: This study selected 72 patients with intestinal polyps who came to our hospital from November 2020 to January 2022. All patients received intestinal polyp treatment as part of gastrointestinal endoscopy. In order to observe the research results, the selected patients were compared and examined in order to better observe the research results. During the examination of all selected patients, the nursing effect and the occurrence of adverse events should be carefully recorded and compared. At the same time, before nursing the selected patients, professional medical staff will evaluate the overall condition of the patients to ensure that the patients can cooperate in the process of this study, and then they can be included in the study. Patients should also take the initiative to inform patients of the research content and purpose, and the research results can be published only with the consent of patients. Results: two different nursing methods had different effects on selected patients, but relatively high-quality nursing methods were preferred by patients, which minimized adverse reactions during the patient's recovery. There were differences in the results across all patients, which better support the data from this study.
文摘Since the first report of use of endoscopy in children in the 1970 s, there has seen an exponential growthin published experience and innovation in the field. In this review article we focus on modern age therapeutic endoscopy practice, explaining use of traditional as well as new and innovative techniques, for diagnosis and treatment of diseases in the paediatric upper gastrointestinal tract.
文摘AIM:Hypertrophied anal papillae and fibrous anal polyps are not given due importance in the proctology practice. They are mostly ignored being considered as normal structures.The present study was aimed to demonstrate that hypertrophied anal papillae and fibrous anal polyps could cause symptoms to the patients and that they should be removed in treatment of patients with chronic fissure in anus. METHODS:Two groups of patients were studied.A hundred patients were studied in group A in which the associated fibrous polyp or papillae were removed by radio frequency surgical device after a lateral subcutaneous sphincterotomy for relieving the sphincter spasm.Another group of a hundred patients who also had papillae or fibrous polyps,were treated by lateral sphincterotomy alone.They were followed up for one year. RESULTS:Eighty-nine percent patients from group A expressed their satisfaction with the treatment in comparison to only 64% from group B who underwent sphincterotomy alone with the papillae or anal polyps left untreated.Group A patients showed a marked reduction with regard to pain and irritation during defecation (P=0.0011), pricking or foreign body sensation in the anus (P=0.0006) and pruritus or wetness around the anal verge (P=0.0008). CONCLUSION:Hypertrophied anal papillae and fibrous anal polyps should be removed during treatment of chronic anal fissure.This would add to effectiveness and completeness of the procedure.
基金Supported by the Key-Area Research and Development Program of Guangdong Province,No.2022B1111070006the Guangdong Innovation Research Team for Higher Education,No.2021KCXTD025.
文摘BACKGROUND While colorectal polyps are not cancerous,some types of polyps,known as adenomas,can develop into colorectal cancer over time.Polyps can often be found and removed by colonoscopy;however,this is an invasive and expensive test.Thus,there is a need for new methods of screening patients at high risk of developing polyps.AIM To identify a potential association between colorectal polyps and small intestine bacteria overgrowth(SIBO)or other relevant factors in a patient cohort with lactulose breath test(LBT)results.METHODS A total of 382 patients who had received an LBT were classified into polyp and non-polyp groups that were confirmed by colonoscopy and pathology.SIBO was diagnosed by measuring LBTderived hydrogen(H)and methane(M)levels according to 2017 North American Consensus recommendations.Logistic regression was used to assess the ability of LBT to predict colorectal polyps.Intestinal barrier function damage(IBFD)was determined by blood assays.RESULTS H and M levels revealed that the prevalence of SIBO was significantly higher in the polyp group than in the non-polyp group(41%vs 23%,P<0.01;71%vs 59%,P<0.05,respectively).Within 90 min of lactulose ingestion,the peak H values in the adenomatous and inflammatory/hyperplastic polyp patients were significantly higher than those in the non-polyp group(P<0.01,and P=0.03,respectively).In 227 patients with SIBO defined by combining H and M values,the rate of IBFD determined by blood lipopolysaccharide levels was significantly higher among patients with polyps than those without(15%vs 5%,P<0.05).In regression analysis with age and gender adjustment,colorectal polyps were most accurately predicted with models using M peak values or combined H and M values limited by North American Consensus recommendations for SIBO.These models had a sensitivity of≥0.67,a specificity of≥0.64,and an accuracy of≥0.66.CONCLUSION The current study made key associations among colorectal polyps,SIBO,and IBFD and demonstrated that LBT has moderate potential as an alternative noninvasive screening tool for colorectal polyps.
基金Supported by the National Natural Science Foundation of China,No.81873253the Shanghai Natural Science Foundation,No.22ZR1458800+1 种基金the Hongkou District Health Committee,No.HKZK2020A01the Xinglin Scholar Program of Shanghai University of Traditional Chinese Medicine,No.[2020]23.
文摘BACKGROUND Colorectal cancer(CRC)is the third most common cancer worldwide,with the fourth highest mortality among all cancers.Reportedly,in addition to adenomas,serrated polyps,which account for 15%-30%of CRCs,can also develop into CRCs through the serrated pathway.Sessile serrated adenomas/polyps(SSAs/Ps),a type of serrated polyps,are easily misdiagnosed during endoscopy.AIM To observe the difference in the Wnt signaling pathway expression in SSAs/Ps patients with different syndrome types.METHODS From January 2021 to December 2021,patients with SSAs/Ps were recruited from the Endoscopy Room of Shanghai Traditional Chinese Medicine-Integrated Hospital,affiliated with Shanghai University of Traditional Chinese Medicine.Thirty cases each of large intestine damp-heat(Da-Chang-Shi-Re,DCSR)syndrome and spleen-stomach weakness(Pi-Wei-Xu-Ruo)syndrome were reported.Baseline comparison of the general data,typical tongue coating,colonoscopy findings,and hematoxylin and eosin findings was performed in each group.The expression of the Wnt pathway-related proteins,namelyβ-catenin,adenomatous polyposis coli,and mutated in colorectal cancer,were analyzed using immunohistochemistry.RESULTS Significant differences were observed with respect to the SSAs/Ps size between the two groups of patients with different syndrome types(P=0.001).The other aspects did not differ between the two groups.The Wnt signaling pathway was activated in patients with SSAs/Ps belonging to both groups,which was manifested asβ-catenin protein translocation into the nucleus.However,SSAs/Ps patients with DCSR syndrome had more nucleation,higherβ-catenin expression,and negative regulatory factor(adenomatous polyposis coli and mutated in colorectal cancer)expression(P<0.0001)than SSA/P patients with Pi-Wei-Xu-Ruo syndrome.In addition,the SSA/P size was linearly correlated with the related protein expression.CONCLUSION Patients with DCSR syndrome had a more obvious Wnt signaling pathway activation and a higher risk of carcinogenesis.A high-quality colonoscopic diagnosis was essential.The thorough assessment of clinical diseases can be improved by combining the diseases of Western medicine with the syndromes of traditional Chinese medicine.
文摘BACKGROUND Gastric Helicobacter pylori(H.pylori)infection is related to chronic gastritis,gastroduodenal ulcer,and gastric malignancies;whether this infection is related to colorectal polyps and colorectal cancer(CRC),remains debatable.AIM To investigate the relationship between gastric H.pylori infection and the risk of colorectal polyps and CRC.METHODS We retrospectively analyzed 3872 patients with colorectal polyps who underwent colonoscopy and pathological diagnosis.We also analyzed 304 patients with primary CRC.The characteristics of these patients were compared with those of the control group,which included 2362 patients with the normal intestinal mucosa.All subjects completed a 14C-urea breath test,bidirectional gastrointestinal endoscopy,and a biopsy on the same day.Data on the number,size,location,and pathology of the polyps,the location,and pathology of the CRC,the detection of H.pylori,and the incidence of H.pylori-associated atrophic gastritis or intestinal metaplasia were obtained.A logistic regression model was used to analyze the relationship between gastric infection due to H.pylori,and the incidence of colorectal polyps and CRC.RESULTS The prevalence of H.pylori infection was higher in the multiple polyps group than in the solitary polyp group and the control group[95%confidence interval(CI)=1.02-1.31,P=0.03;95%CI:2.12-2.74,P<0.001].The patients with adenomatous polyps had a higher incidence of H.pylori infection than patients with non-adenomatous polyps[59.95%vs 51.75%,adjusted odds ratio(OR)=1.41,95%CI:1.24-1.60,P<0.01].Patients with H.pylori-associated atrophic gastritis or intestinal metaplasia were at high risk of CRC(adjusted OR=3.46,95%CI:2.63-4.55,P<0.01;adjusted OR=4.86,95%CI:3.22-7.34,P<0.01,respectively).The size and location of the polyps,the histopathological characteristics and the location of CRC were not related to H.pylori infection.CONCLUSION Our study demonstrates that the incidence of gastric H.pylori infection and H.pylori-associated atrophic gastritis or intestinal metaplasia elevates the risk of colorectal polyps and CRC.
基金Supported by The National Natural Science Foundation of China,No.81271576
文摘AIM: To present our initial experience regarding the feasibility of ultrasound virtual endoscopy(USVE) and its measurement reliability for polyp detection in an in vitro study using pig intestine specimens.METHODS: Six porcine intestine specimens containing 30 synthetic polyps underwent USVE, computed tomography colonography(CTC) and optical colonoscopy(OC) for polyp detection. The polyp measurement defined as the maximum polyp diameter on twodimensional(2D) multiplanar reformatted(MPR) planes was obtained by USVE, and the absolute measurement error was analyzed using the direct measurement as the reference standard.RESULTS: USVE detected 29(96.7%) of 30 polyps, remaining a 7-mm one missed. There was one falsepositive finding. Twenty-six(89.7%) of 29 reconstructedimages were clearly depicted, while 29(96.7%) of 30 polyps were displayed on CTC with one false-negative finding. In OC, all the polyps were detected. The intraclass correlation coefficient was 0.876(95%CI: 0.745-0.940) for measurements obtained with USVE. The pooled absolute measurement errors ± the standard deviations of the depicted polyps with actual sizes ≤ 5 mm, 6-9 mm, and ≥ 10 mm were 1.9 ± 0.8 mm, 0.9 ± 1.2 mm, and 1.0 ± 1.4 mm, respectively.CONCLUSION: USVE is reliable for polyp detection and measurement in in vitro study.
文摘BACKGROUND Although substantial evidence supports the advantages of cold snare polypectomy(CSP)in terms of polypectomy efficacy and reduced postoperative adverse events,few studies have examined the cost differences between CSP and traditional endoscopic mucosal resection(EMR)for the treatment of intestinal polyps.AIM To compare the efficacy-cost of EMR and CSP in the treatment of intestinal polyps.METHODS A total of 100 patients with intestinal polyps were included in the retrospective data of our hospital from April 2022 to May 2023.According to the treatment methods,they were divided into EMR(n=46)group and CSP(n=54)group.The baseline data of the two groups were balanced by 1:1 propensity score matching(PSM),and the cost-effectiveness analysis was performed on the two groups after matching.The recurrence rate of the two groups of patients was followed up for 1 year,and they were divided into recurrence group and non-recurrence group according to whether they recurred.Multivariate logistic regression analysis was used to screen out the influencing factors affecting the recurrence of intestinal polyps after endoscopic resection.RESULTS Significant disparities were observed in the number of polyps and smoking background between the two groups before PSM(P<0.05).Following PSM,the number of polyps and smoking history were well balanced between the EMR and CSP groups.The direct cost incurred by the CSP group was markedly higher than that incurred by the EMR group.Concurrently,the cost-effectiveness ratio in the CSP group was substantially reduced when juxtaposed with that in the EMR group(P<0.05).Upon completion of the 1-year follow-up,the rate of recurrence after endoscopic intestinal polypectomy was 38.00%.Multivariate methods revealed that age≥60 years,male sex,number of polyps≥3,and pathological type of adenoma were risk factors for recurrence after endoscopic intestinal polypectomy(all P<0.05).CONCLUSION CSP was more cost-effective for the treatment of intestinal polyps.An age≥60 years,male sex,having a number of polyps≥3,and pathological type of adenoma are independent influencing factors for recurrence.
文摘AIM:To investigate biological prevention with flavonoids the recurrence risk of neoplasia was studied in patients with resected colorectal cancer and after adenoma polypectomy.METHODS:Eighty-seven patients,36 patients with resected colon cancer and 51 patients after polypectomy,were divided into 2 groups:one group was treated with a flavonoid mixture(daily standard dose 20 mg apigenin and 20 mg epigallocathechin-gallat,n=31)and compared with a matched control group(n=56).Both groups were observed for 3-4 years by surveillance colonoscopy and by questionnaire.RESULTS:Of 87 patients enrolled in this study,36 had resected colon cancer and 29 of these patients had surveillance colonoscopy.Among the flavonoid-treated patients with resected colon cancer(n=14),there was no cancer recurrence and one adenoma developed.In contrast the cancer recurrence rate of the 15 matched untreated controls was 20%(3 of 15)and adenomas evolved in 4 of those patients(27%).The combined recurrence rate for neoplasia was 7%(1 of 14)in the treated patients and 47%(7 of 15)in the controls(P=0.027).CONCLUSION:Sustained long-term treatment with a flavonoid mixture could reduce the recurrence rate of colon neoplasia in patients with resected colon cancer.
