BACKGROUND Appendicitis is an abdominal medical emergency and can be of various types.It can lead to a series of gastrointestinal symptoms and can affect health status.Therefore,attention should be paid to the diagnos...BACKGROUND Appendicitis is an abdominal medical emergency and can be of various types.It can lead to a series of gastrointestinal symptoms and can affect health status.Therefore,attention should be paid to the diagnosis of appendicitis to improve prognosis.AIM To assess the value of transabdominal superficial ultrasonography(TASU)in the clinical diagnosis of various types of appendicitis.METHODS A total of 100 patients suspected to have acute appendicitis that were admitted to our hospital between July 2022 and July 2024 were selected for this study.All of them underwent conventional abdominal ultrasonography and TASU.Taking surgical pathology as the gold standard,the diagnostic efficacy of the two ultrasonographic examinations was compared,and the ultrasonographic features of patients with different types of appendicitis were analyzed.RESULTS Comparison with the gold standard showed that among the 100 patients suspected of appendicitis,72 cases were diagnosed as appendicitis while 28 cases were deemed to be normal.Compared with conventional abdominal ultrasonography,TASU displayed a higher diagnostic efficiency(P<0.05).Among the 72 patients with acute appendicitis,22 cases were diagnosed as simple appendicitis,26 cases as suppurative appendicitis,and 24 cases as gangrenous appendicitis.TASU was more effective in the diagnosis of the various types of appendicitis,and the difference was significant between groups(P<0.05).Ultrasonography radiographs revealed an enlarged appendix with a tubular anechoic area,a widened lumen,with a visible occlusion or stercoral shadow and a cystic mass in the parenchyma.CONCLUSION TASU can accurately diagnose appendicitis and also be used to identify the various types of appendicitis,thereby having application value.展开更多
Objective: To evaluate the efficacy of endovenous radiofrequency ablation (RFA) and laser ablation (EVLA) in the treatment of superficial varicose veins of the lower extremities. Methods: Seventy-eight patients with s...Objective: To evaluate the efficacy of endovenous radiofrequency ablation (RFA) and laser ablation (EVLA) in the treatment of superficial varicose veins of the lower extremities. Methods: Seventy-eight patients with superficial varicose veins treated at a hospital between April 2022 and May 2023 were selected and divided into a radiofrequency ablation group (RFA group;39 cases) and a laser ablation group (EVLA group;39 cases) based on the treatment method. Operation time, postoperative recovery duration, venous clinical severity score (VCSS) changes, complication rates, closure rates, and recurrence rates were compared between the groups at 1 month, 3 months, and 12 months postoperatively. The postoperative therapeutic outcomes were comprehensively evaluated. Results: No significant differences in age, gender, disease grade, or disease course were observed between the groups (P > 0.05). The superficial varicose vein closure rate was 100% in both groups at 1 and 3 months postoperatively. At 12 months, the closure rate was 94.87% in the RFA group and 97.43% in the EVLA group, with no statistically significant difference (P > 0.05). No significant differences were observed in VCSS changes or complication incidence between the groups (P > 0.05). Conclusion: Radiofrequency ablation and laser ablation demonstrate comparable efficacy and safety in the treatment of superficial varicose veins of the lower extremities.展开更多
In this editorial,we comment on the article by Wang et al published in the recent issue of the World Journal of Gastroenterology in 2023.We focused on identifying risk factors for lymph node metastasis(LNM)in superfic...In this editorial,we comment on the article by Wang et al published in the recent issue of the World Journal of Gastroenterology in 2023.We focused on identifying risk factors for lymph node metastasis(LNM)in superficial esophageal squamous cell carcinoma(SESCC)patients and how to construct a simple and reliable clinical prediction model to assess the risk of LNM in SESCC patients,thereby helping to guide the selection of an appropriate treatment plan.The current standard treatment for SESCC is radical esophagectomy with lymph node dissection.However,esophagectomy is associated with considerable morbidity and mortality.Endoscopic resection(ER)offers a safer and less invasive alternative to surgical resection and can enable the patient's quality of life to be maintained while providing a satisfactory outcome.However,since ER is a localized treatment that does not allow for lymph node dissection,the risk of LNM in SESCC limits the effectiveness of ER.Understanding LNM status can aid in determining whether patients with SESCC can be cured by ER without the need for additional esophagectomy.Previous studies have shown that tumor size,macroscopic type of tumor,degree of differentiation,depth of tumor invasion,and lymphovascular invasion are factors associated with LNM in patients with SESCC.In addition,tumor budding is commonly associated with LNM,recurrence,and distant metastasis,but this topic has been less covered in previous studies.By comprehensively evaluating the above risk factors for LNM,useful evidence can be obtained for doctors to select appropriate treatments for SESCC patients.展开更多
BACKGROUND Drug-eluting stents(DES)are used to treat lower extremity arterial disease.During DES treatment,aneurysmal degeneration occasionally occurs,especially with fluoropolymer-based DES.However,the incidence of p...BACKGROUND Drug-eluting stents(DES)are used to treat lower extremity arterial disease.During DES treatment,aneurysmal degeneration occasionally occurs,especially with fluoropolymer-based DES.However,the incidence of pseudoaneurysms after DES placement is rarely reported in the lower extremity region,although there have been several reports on pseudoaneurysm formation after DES placement in the coronary artery region.CASE SUMMARY We report the case of a 64-year-old man who presented with fever and pain in his left hand after dialysis.Bacteremia was diagnosed by blood culture,and after admission,he developed pain on the medial side of the right thigh.A pseudoaneurysm was observed in the right superficial femoral artery(SFA)at the proximal end of a previously placed DES.The bacteremia was thought to have been caused by a pseudoaneurysm of the left superficial brachial artery,and the pseudoaneurysm of the left superficial brachial artery was removed after antibiotic treatment.The pseudoaneurysm of the right SFA rapidly expanded after admission,but the expansion rate was reduced after infection control.Seven months after the first admission,the pseudoaneurysm of the left SFA was re-moved and in situ revascularization performed using a rifampicin-soaked Dacron graft.CONCLUSION Although pseudoaneurysm after DES placement in the lower extremity region is rare,it must be considered in patients with bacteremia.展开更多
[Objectives] To investigate the clinical efficacy of Chaihu Shugan Powder on chronic superficial gastritis with liver-stomach disharmony syndrome.[Methods] A total of 72 patients diagnosed with chronic superficial gas...[Objectives] To investigate the clinical efficacy of Chaihu Shugan Powder on chronic superficial gastritis with liver-stomach disharmony syndrome.[Methods] A total of 72 patients diagnosed with chronic superficial gastritis characterized by liver-stomach disharmony syndrome between September 2023 and August 2024 were randomly assigned into two groups. The control group received treatment with western medicine, and the treatment group was administered both western medicine and Chaihu Shugan Powder. The therapeutic effects, TCM syndrome scores, adverse reactions, and recurrence rate were compared between the two groups.[Results] The total effective rate was 88.89% in the treatment group and 80.56% in the control group. The differences between the two groups were statistically significant ( P <0.05), indicating that the improvement observed in the treatment group was significantly greater than that in the control group ( P <0.05). In comparison to pre-treatment levels, the TCM syndrome scores for both patient groups exhibited a reduction following treatment. Notably, the extent of this reduction in the treatment group was significantly greater than that observed in the control group ( P <0.05). Neither group of patients experienced serious adverse reactions during treatment. Furthermore, the recurrence rate among patients in the control group was found to be higher than that in the treatment group.[Conclusions] The clinical efficacy of Chaihu Shugan Powder in the treatment of chronic superficial gastritis with liver-stomach disharmony syndrome is significant, demonstrating a notable reduction in the recurrence rate of the condition.展开更多
Superficial serrated adenoma (SuSA) is a new subtype of serrated lesions proposed in recent years, most of which are located in the sigmoid colon or rectum, with typical mixed adenoma and serrated pathological feature...Superficial serrated adenoma (SuSA) is a new subtype of serrated lesions proposed in recent years, most of which are located in the sigmoid colon or rectum, with typical mixed adenoma and serrated pathological features, and its molecular features are high frequency of KRAS mutation and RSPO fusion or overexpression. At present, it is believed that SuSA has two subtypes: traditional serrated adenoma (TSA)-associated SuSA and isolated SuSA. Solitary SuSA showed faded pedicle-free protuberant lesions under endoscope and lobulated, pp (pit pattern) classification was type II and type IIIH, TSA-associated SuSA showed double-layer eminence, SuSA part showed white flat eminence, pp classification showed type II and IIIH, TSA part showed red tone high eminence, pp was IVH type. SuSA can develop into colorectal cancer through the evolution of TSA, and it can also directly develop into MSS colorectal cancer. In view of the superficial understanding of SuSA and the lack of a complete description of SuSA, this paper review the research progress of SuSA at home and abroad from the origin, endoscope features, histopathological features, molecular biology, differential diagnosis and treatment of SuSA, in order to better promote the understanding and clinical diagnosis of lesions.展开更多
Purpose: To evaluate optical coherence tomography angiography (OCT-A) data obtained from the superficial retinal capillary plexus of patients with retinal vein occlusion and comparative analysis with data registered f...Purpose: To evaluate optical coherence tomography angiography (OCT-A) data obtained from the superficial retinal capillary plexus of patients with retinal vein occlusion and comparative analysis with data registered from unaffected fellow eyes. Methods: The examined patients were classified into 2 groups: group 1—eyes with established retinal vein occlusion (n = 29) and group 2—unaffected fellow eyes of patients with retinal vein occlusion (n = 24). The scanning protocol “Angiography 3 × 3 mm” of Zeiss Cirrus HD-OCT 6000, AngioPlex Metrix was used to evaluate the retinal superficial capillary plexus. The analyzed parameters were vascular density and perfusion density, as well as the area, perimeter, and circularity of the foveolar avascular zone (FAZ). Results: The comparative analysis of FAZ parameters at the superficial capillary plexus (SCP) between group 1 (eyes with retinal vein occlusion) and group 2 (unaffected fellow eyes) showed significant results for the three parameters, respectively area (p = 0.003), perimeter (p ≤ 0.001), and circularity (p = 0.011) of FAZ. The comparative analysis of the vascular network at SCP in patients with diagnosed retinal vein occlusion and unaffected fellow eyes showed significant results for vascular density (VD) in the central (p = 0.038) and inner (p ≤ 0.001) zones as well as total VD (p ≤ 0.001) were statistically significant. Moreover, the results obtained in the study of vascular perfusion (VP) indicated significant results in the inner zone (p ≤ 0.001) and total VP (p = 0.001). Vascular perfusion in the central zone (p = 0.116) was the only parameter not to meet significant results. Conclusion: The current study observed a significant enlargement of the FAZ and loss of its circularity, along with a reduction in vascular network parameters at the superficial retinal capillary plexus level.展开更多
Objective To observe the correlation between analgesic effect and duration of analgesic effect of superficial needling for shoulder pain of shoulderhand syndrome（SHS） after stroke, so as to screen the best time peri...Objective To observe the correlation between analgesic effect and duration of analgesic effect of superficial needling for shoulder pain of shoulderhand syndrome（SHS） after stroke, so as to screen the best time period of analgesia. Methods A total of 120 patients with SHS after stroke（stage I） were recruited and superficial needling therapy was applied. Two obvious tenderness points on the affected shoulder of patients were found out. The site 80–100 mm down each tenderness point was selected for superficial needling. Bimanual needling technique was applied after inserting needles. The surrounding of tenderness points was pinched and grasped by left hand above the needling, and the technique of green dragon swaying tail was applied by right hand. The needles at each acupoint were manipulated for3 min and retained for 30 min. The analgesic effect was evaluated dynamically by visual analogue scale（VAS） in 120 patients before treatment, immediately after treatment, 30 min after treatment, 1 h after treatment and 24 h after treatment. The analgesic effects at different time were statistically analyzed by generalized estimating equation. Results The mean values of VAS were 7.483, 3.950, 4.767, 5.917 and 7.217, respectively, before treatment, immediately after treatment, 30 min after treatment, 1 h after treatment and 24 h after treatment. The difference of analgesic effect at different time was statistically significant（P〈0.01）; the difference of analgesic effect of superficial needling in treatment of SHS after stroke was significant between immediately after treatment and 30 min after treatment（both P〈0.05）, while there was no significant difference between 1 h after treatment and 24 h after treatment（both P〈0.05）. Conclusion Analgesic effect of superficial needling for shoulder pain of SHS after stroke was different at different time points and decreased over time; analgesic effect was the most significant immediately after treatment and the optimal duration of analgesic effect was from immediately to 30 min after superficial needling therapy.展开更多
In the present study, we aimed to evaluate the efficiency and cost ofpirarubicin （THP） and epirubicin （EPI） as prophylaxis for recurrence in patients with superficial bladder tumors by bladder instillation after t...In the present study, we aimed to evaluate the efficiency and cost ofpirarubicin （THP） and epirubicin （EPI） as prophylaxis for recurrence in patients with superficial bladder tumors by bladder instillation after transurethral resection of a bladder tumor （TUR-BT）. Standardized evaluation was performed by analyzing research papers. Moreover, expert opinions, studies and cost data were combined to evaluate cost of THP and EPI. With systematic review and expert opinions, we confirmed that THP and EPI were not statistically different when they were used as prophylaxis for recurrence in patients with superficial bladder tumors by bladder instillation after TUR-BT. Moreover, the cost evaluation of THP and EPI needs to be separately discussed according to original/generic drug. The original drug THP had more cost advantages than EPI, while generic EPI had more cost advantages than THP.展开更多
AIM:To assess expression of matrix metalloproteinases 2(MMP2)and MMP9 in gastric cancer,superficial gastritis and normal mucosa,and to measure metalloproteinase activity.METHODS:MMP2 and MMP9 mRNA expression was deter...AIM:To assess expression of matrix metalloproteinases 2(MMP2)and MMP9 in gastric cancer,superficial gastritis and normal mucosa,and to measure metalloproteinase activity.METHODS:MMP2 and MMP9 mRNA expression was determined by quantitative real-time polymerase chain reaction.Normalization was carried out using three different factors.Proteins were analyzed by quantitative gelatin zymography(qGZ).RESULTS:18S ribosomal RNA(18SRNA)was very highly expressed,while hypoxanthine ribosyltransferase-1(HPRT-1)was moderately expressed.MMP2 was highly expressed,while MMP9 was not detected or lowly expressed in normal tissues,moderately or highly expressed in gastritis and highly expressed in cancer.Relative expression of 18SRNA and HPRT-1 showed no significant differences.Significant differences in MMP2 and MMP9 were found between cancer and normal tissue,but not between gastritis and normal tissue.Absolute quantification of MMP9 echoed this pattern,but differential expression of MMP2 proved conflictive.Analysis by qGZ indicated significant differences between cancer and normal tissue in MMP-2,total MMP-9,250 and 110 kDa bands.CONCLUSION:MMP9 expression is enhanced in gastric cancer compared to normal mucosa;interpretation of differential expression of MMP2 is difficult to establish.展开更多
AIM: To investigate the effectiveness of endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) in treating superficial esophageal cancer (SEC).
AIM To evaluate the clinical outcomes of patients who underwent endoscopic submucosal tunnel dissection(ESTD) for esophageal squamous cell carcinoma(ESCC) and precancerous lesions.METHODS ESTD was performed in 289 pat...AIM To evaluate the clinical outcomes of patients who underwent endoscopic submucosal tunnel dissection(ESTD) for esophageal squamous cell carcinoma(ESCC) and precancerous lesions.METHODS ESTD was performed in 289 patients. The clinical outcomes of the patients and pathological features of the lesions were retrospectively reviewed.RESULTS A total of 311 lesions were included in the analysis. The en bloc rate, complete resection rate, and curative resection rate were 99.04%, 81.28%, and 78.46%, respectively. The ESTD procedure time was 102.4 ± 35.1 min, the mean hospitalization time was 10.3 ± 2.8 d, and the average expenditure was 3766.5 ± 846.5 dollars. The intraoperative bleeding rate was 6.43%, the postoperative bleeding rate was 1.61%, the perforation rate was 1.93%, and the postoperative infection rate was 9.65%. Esophageal stricture and positive margin were severe adverse events, with an incidence rate of 14.79% and 15.76%, respectively. No tumor recurrence occurred during the follow-up period. CONCLUSION ESTD for ESCC and precancerous lesions is feasible and relatively safe, but for large mucosal lesions, the rate of esophageal stricture and positive margin is high.展开更多
The Yali pear（Pyrus bretschneideri Rehd.） is susceptible to superficial scald during prolonged cold storage and at shelf life. This study investigated the effects of 1-methylcyclopropene（1-MCP） and modified atmosp...The Yali pear（Pyrus bretschneideri Rehd.） is susceptible to superficial scald during prolonged cold storage and at shelf life. This study investigated the effects of 1-methylcyclopropene（1-MCP） and modified atmosphere packaging（MAP） on changes of fruit quality and superficial scald during cold storage and at shelf life in Yali pear. Compared with MAP, the combination of MAP and 1-MCP（MAP＋1-MCP） treatment reduced the carbon dioxide and ethylene content inside the packaging bag. The 1-MCP, MAP, and MAP＋1-MCP treatments reduced the superficial scald index, malondialdehyde content, O2^-· production rate and relative conductivity and inhibited the accumulation of α-farnesene and conjugated trienes in the peel. 1-MCP and MAP＋1-MCP treatments maintained a higher phenolic content and enhanced the catalase and superoxide dismutase activities in the fruit, while reduced activities of lipoxygenase and polyphenol oxidase in the peel preceding the onset of superficial scald. Comprehensive analysis indicated that the MAP＋1-MCP treatment is the most effective method tested for improving the quality of Yali pears during cold storage and at shelf life.展开更多
Therapeutic endoscopy plays a major role in the management of gastrointestinal (GI) neoplasia. Its indications can be generalized into four broad categories; to remove or obliterate neoplastic lesion, to palliate mali...Therapeutic endoscopy plays a major role in the management of gastrointestinal (GI) neoplasia. Its indications can be generalized into four broad categories; to remove or obliterate neoplastic lesion, to palliate malignant obstruction, or to treat bleeding. Only endoscopic resection allows complete histological staging of the cancer, which is critical as it allows stratification and refinement for further treatment. Although other endoscopic techniques, such as ablation therapy, may also cure early GI cancer, they can not provide a definitive pathological specimen. Early stage lesions reveal low frequency of lymph node metastasis which allows for less invasive treatments and thereby improving the quality of life when compared to surgery. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are now accepted worldwide as treatment modalities for early cancers of the GI tract.展开更多
Chronic superficial gastritis(CSG)is a common disease of the digestive system that possesses a serious pathogenesis.Jinhong tablet(JHT),a traditional Chinese medicine(TCM)prescription,exerts therapeutic effects agains...Chronic superficial gastritis(CSG)is a common disease of the digestive system that possesses a serious pathogenesis.Jinhong tablet(JHT),a traditional Chinese medicine(TCM)prescription,exerts therapeutic effects against CSG.However,the molecular basis of its therapeutic effect has not been clarified.Herein,we employed ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry(UPLC-Q/TOF-MS)based chemical profile identification to determine the chemical components in JHT.Further,we applied network pharmacology to illustrate its molecular mechanisms.A total of 96 chemical constituents were identified in JHT,31 of which were confirmed using reference standards.Based on the bioinformatics analysis using the symptom-guided pharmacological networks of“chi,”“blood,”“pain,”and“inflammation,”and target screening through the interaction probabilities between compounds and targets,matrix metalloproteinase 2(MMP2),dopamine d2 receptor(DRD2),and Aldo-keto reductase family 1 member B1(AKR1B1)were identified as key targets in the therapeutic effect exhibited by JHT against CSG.Moreover,according to the inhibitory activities presented in the literature and binding mode analysis,the structural types of alkaloids,flavonoids,organic acids,including chlorogenic acid(10),caffeic acid(13),(-)-corydalmine(33),(-)-isocorypalmine(36),isochlorogenic acid C(38),isochlorogenic acid A(41),quercetin-3-O-a-L-rhamnoside(42),isochlorogenic acid B(47),quercetin(63),and kaempferol(70)tended to show remarkable activities against CSG.Owing to the above findings,we systematically identified the chemical components of JHT and revealed its molecular mechanisms based on the symptoms associated with CSG.展开更多
AIM To simplify the diagnostic criteria for superficial esophageal squamous cell carcinoma(SESCC) on Narrow Band Imaging combined with magnifying endoscopy(NBI-ME).METHODS This study was based on the post-hoc analysis...AIM To simplify the diagnostic criteria for superficial esophageal squamous cell carcinoma(SESCC) on Narrow Band Imaging combined with magnifying endoscopy(NBI-ME).METHODS This study was based on the post-hoc analysis of a randomized controlled trial. We performed NBI-ME for 147 patients with present or a history of squamous cell carcinoma in the head and neck, or esophagus between January 2009 and June 2011. Two expert endoscopistsdetected 89 lesions that were suspicious for SESCC lesions, which had been prospectively evaluated for the following 6 NBI-ME findings in real time: "intervascular background coloration"; "proliferation of intrapapillary capillary loops(IPCL)"; and "dilation", "tortuosity", "change in caliber", and "various shapes(VS)" of IPCLs(i.e., Inoue's tetrad criteria). The histologic examination of specimens was defined as the gold standard for diagnosis. A stepwise logistic regression analysis was used to identify candidates for the simplified criteria from among the 6 NBI-ME findings for diagnosing SESCCs. We evaluated diagnostic performance of the simplified criteria compared with that of Inoue's criteria.RESULTS Fifty-four lesions(65%) were histologically diagnosed as SESCCs and the others as low-grade intraepithelial neoplasia or inflammation. In the univariate analysis, proliferation, tortuosity, change in caliber, and VS were significantly associated with SESCC(P < 0.01). The combination of VS and proliferation was statistically extracted from the 6 NBI-ME findings by using the stepwise logistic regression model. We defined the combination of VS and proliferation as simplified dyad criteria for SESCC. The areas under the curve of the simplified dyad criteria and Inoue's tetrad criteria were 0.70 and 0.73, respectively. No significant difference was shown between them. The sensitivity, specificity, and accuracy of diagnosis for SESCC were 77.8%, 57.1%, 69.7% and 51.9%, 80.0%, 62.9% for the simplified dyad criteria and Inoue's tetrad criteria, respectively.CONCLUSION The combination of proliferation and VS may serve as simplified criteria for the diagnosis of SESCC using NBIME.展开更多
Objective To evaluate the gastric microbiome in patients with chronic superficial gastritis(CSG)and intestinal metaplasia(IM)and investigate the influence of Helicobacter pylori(H.pylori)on the gastric microbiome.Meth...Objective To evaluate the gastric microbiome in patients with chronic superficial gastritis(CSG)and intestinal metaplasia(IM)and investigate the influence of Helicobacter pylori(H.pylori)on the gastric microbiome.Methods Gastric mucosa tissue samples were collected from 54 patients with CSG and IM,and the patients were classified into the following four groups based on the state of H.pylori infection and histology:H.pylori-negative CSG(n=24),H.pylori-positive CSG(n=14),H.pylori-negative IM(n=11),and H.pylori-positive IM(n=5).The gastric microbiome was analyzed by 16S rRNA gene sequencing.Results H.pylori strongly influenced the bacterial abundance and diversity regardless of CSG and IM.In H.pylori-positive subjects,the bacterial abundance and diversity were significantly lower than in H.pylori-negative subjects.The H.pylori-negative groups had similar bacterial composition and bacterial abundance.The H.pylori-positive groups also had similar bacterial composition but different bacterial relative abundance.The relative abundance of Neisseria,Streptococcus,Rothia,and Veillonella were richer in the I-HP group than in G-HP group,especially Neisseria(t=175.1,P<0.001).Conclusions The gastric microbial abundance and diversity are lower in H.pylori-infected patients regardless of CSG and IM.Compared to H.pylori-positive CSG group and H.pylori-positive IM,the relative abundance of Neisseria,Streptococcus,Rothia,and Veillonella is higher in H.pylori-positive patients with IM than in H.pylori-positive patients with CSG,especially Neisseria.展开更多
The diagnostic and treatment guidelines of superficial non-ampullary duodenal tumors have not been standardized due to their low prevalence.Previous reports suggested that a superficial adenocarcinoma(SAC) should be t...The diagnostic and treatment guidelines of superficial non-ampullary duodenal tumors have not been standardized due to their low prevalence.Previous reports suggested that a superficial adenocarcinoma(SAC) should be treated via local resection because of its low risk of lymph node metastasis,whereas a highgrade adenoma(HGA) should be resected because of its high risk of progression to adenocarcinoma.Therefore,pretreatment diagnosis of SAC or HGA is important to determine the appropriate treatment strategy.There are certain endoscopic features known to be associated with SAC or HGA,and current practice prioritizes the endoscopic and biopsy diagnosis of these conditions.Surgical treatment of these duodenal lesions is often related to high risk of morbidity,and therefore endoscopic resection has become increasingly common in recent years.Endoscopic mucosal resection(EMR) and endoscopic submucosal dissection(ESD) are the commonly performed endoscopic resection methods.EMR is preferred due to its lower risk of adverse events;however,it has a higher risk of recurrence than ESD.Recently,a new and safer endoscopic procedure that reduces adverse events from EMR or ESD has been reported.展开更多
BACKGROUND Adverse events during endoscopic submucosal dissection(ESD)of superficial esophageal neoplasms,such as perforation and bleeding,have been welldocumented.However,the Mallory-Weiss Tear(MWT)during esophageal ...BACKGROUND Adverse events during endoscopic submucosal dissection(ESD)of superficial esophageal neoplasms,such as perforation and bleeding,have been welldocumented.However,the Mallory-Weiss Tear(MWT)during esophageal ESD remains under investigation.AIM To investigate the incidence and risk factors of the MWT during esophageal ESD.METHODS From June 2014 to July 2017,patients with superficial esophageal neoplasms who received ESD in our institution were retrospectively analyzed.The clinicopathological characteristics of the patients were collected.Patients were divided into an MWT group and non-MWT group based on whether MWT occurred during ESD.The incidence of MWTs was determined,and the risk factors for MWT were then further explored.RESULTS A total of 337 patients with 373 lesions treated by ESD were analyzed.Twenty patients developed MWTs during ESD(5.4%).Multivariate analysis identified that female sex(OR=5.36,95%CI:1.47-19.50,P=0.011)and procedure time longer than 88.5 min(OR=3.953,95%CI:1.497-10.417,P=0.005)were independent risk factors for an MWT during ESD.The cutoff value of the procedure time for an MWT was 88.5 min(sensitivity,65.0%;specificity,70.8%).Seven of the MWT patients received endoscopic hemostasis.All patients recovered satisfactorily without surgery for the laceration.CONCLUSION The incidence of MWTs during esophageal ESD was much higher than expected.Although most cases have a benign course,fatal conditions may occur.We recommend inspection of the stomach during and after the ESD procedure for timely management in cases of bleeding MWTs or even perforation outside of the procedure region.展开更多
BACKGROUND Superficial CD34-positive fibroblastoma(SCPFT)is a newly discovered mesenchymal tumor characterized by high polymorphism,low mitotic rate,and diffuse CD34-positive reactions.AIM To further determine the cli...BACKGROUND Superficial CD34-positive fibroblastoma(SCPFT)is a newly discovered mesenchymal tumor characterized by high polymorphism,low mitotic rate,and diffuse CD34-positive reactions.AIM To further determine the clinicopathological features of SCPFT.METHODS We retrospectively analyzed the clinicopathological data,immunohistochemistry results,and differential diagnoses of four patients with SCPFT and performed a literature review.Relevant fusion genes were also detected.RESULTS The tumors were all located in the lower extremities and presented as slowgrowing painless masses located in the dermis and subcutaneous tissue.Microscopically,the tumors were composed of spindle-shaped to epithelioid cells with scattered abnormal and pleomorphic nuclei on a fibrous or fibromyxoid background.Necrosis was not found in the tumor tissues,and mitotic figures were rare.Immunohistochemically,the tumor cells were strongly positive for vimentin and CD34,and CKpan showed focal positivity in two tumors.All four patients were followed(13-57 mo,mean 35 mo),and one patient experienced local recurrence.CONCLUSION SCPFT is a newly discovered borderline mesenchymal tumor that can locally recur or even metastasize.Familiarity with its clinicopathological features will help avoid confusion with skin mesenchymal tumors with similar features.展开更多
文摘BACKGROUND Appendicitis is an abdominal medical emergency and can be of various types.It can lead to a series of gastrointestinal symptoms and can affect health status.Therefore,attention should be paid to the diagnosis of appendicitis to improve prognosis.AIM To assess the value of transabdominal superficial ultrasonography(TASU)in the clinical diagnosis of various types of appendicitis.METHODS A total of 100 patients suspected to have acute appendicitis that were admitted to our hospital between July 2022 and July 2024 were selected for this study.All of them underwent conventional abdominal ultrasonography and TASU.Taking surgical pathology as the gold standard,the diagnostic efficacy of the two ultrasonographic examinations was compared,and the ultrasonographic features of patients with different types of appendicitis were analyzed.RESULTS Comparison with the gold standard showed that among the 100 patients suspected of appendicitis,72 cases were diagnosed as appendicitis while 28 cases were deemed to be normal.Compared with conventional abdominal ultrasonography,TASU displayed a higher diagnostic efficiency(P<0.05).Among the 72 patients with acute appendicitis,22 cases were diagnosed as simple appendicitis,26 cases as suppurative appendicitis,and 24 cases as gangrenous appendicitis.TASU was more effective in the diagnosis of the various types of appendicitis,and the difference was significant between groups(P<0.05).Ultrasonography radiographs revealed an enlarged appendix with a tubular anechoic area,a widened lumen,with a visible occlusion or stercoral shadow and a cystic mass in the parenchyma.CONCLUSION TASU can accurately diagnose appendicitis and also be used to identify the various types of appendicitis,thereby having application value.
基金supported by the 2024 University Scientific Research Project of Guangzhou Education Bureau(Project No.24312286Certificate No.gd20249983112).
文摘Objective: To evaluate the efficacy of endovenous radiofrequency ablation (RFA) and laser ablation (EVLA) in the treatment of superficial varicose veins of the lower extremities. Methods: Seventy-eight patients with superficial varicose veins treated at a hospital between April 2022 and May 2023 were selected and divided into a radiofrequency ablation group (RFA group;39 cases) and a laser ablation group (EVLA group;39 cases) based on the treatment method. Operation time, postoperative recovery duration, venous clinical severity score (VCSS) changes, complication rates, closure rates, and recurrence rates were compared between the groups at 1 month, 3 months, and 12 months postoperatively. The postoperative therapeutic outcomes were comprehensively evaluated. Results: No significant differences in age, gender, disease grade, or disease course were observed between the groups (P > 0.05). The superficial varicose vein closure rate was 100% in both groups at 1 and 3 months postoperatively. At 12 months, the closure rate was 94.87% in the RFA group and 97.43% in the EVLA group, with no statistically significant difference (P > 0.05). No significant differences were observed in VCSS changes or complication incidence between the groups (P > 0.05). Conclusion: Radiofrequency ablation and laser ablation demonstrate comparable efficacy and safety in the treatment of superficial varicose veins of the lower extremities.
文摘In this editorial,we comment on the article by Wang et al published in the recent issue of the World Journal of Gastroenterology in 2023.We focused on identifying risk factors for lymph node metastasis(LNM)in superficial esophageal squamous cell carcinoma(SESCC)patients and how to construct a simple and reliable clinical prediction model to assess the risk of LNM in SESCC patients,thereby helping to guide the selection of an appropriate treatment plan.The current standard treatment for SESCC is radical esophagectomy with lymph node dissection.However,esophagectomy is associated with considerable morbidity and mortality.Endoscopic resection(ER)offers a safer and less invasive alternative to surgical resection and can enable the patient's quality of life to be maintained while providing a satisfactory outcome.However,since ER is a localized treatment that does not allow for lymph node dissection,the risk of LNM in SESCC limits the effectiveness of ER.Understanding LNM status can aid in determining whether patients with SESCC can be cured by ER without the need for additional esophagectomy.Previous studies have shown that tumor size,macroscopic type of tumor,degree of differentiation,depth of tumor invasion,and lymphovascular invasion are factors associated with LNM in patients with SESCC.In addition,tumor budding is commonly associated with LNM,recurrence,and distant metastasis,but this topic has been less covered in previous studies.By comprehensively evaluating the above risk factors for LNM,useful evidence can be obtained for doctors to select appropriate treatments for SESCC patients.
文摘BACKGROUND Drug-eluting stents(DES)are used to treat lower extremity arterial disease.During DES treatment,aneurysmal degeneration occasionally occurs,especially with fluoropolymer-based DES.However,the incidence of pseudoaneurysms after DES placement is rarely reported in the lower extremity region,although there have been several reports on pseudoaneurysm formation after DES placement in the coronary artery region.CASE SUMMARY We report the case of a 64-year-old man who presented with fever and pain in his left hand after dialysis.Bacteremia was diagnosed by blood culture,and after admission,he developed pain on the medial side of the right thigh.A pseudoaneurysm was observed in the right superficial femoral artery(SFA)at the proximal end of a previously placed DES.The bacteremia was thought to have been caused by a pseudoaneurysm of the left superficial brachial artery,and the pseudoaneurysm of the left superficial brachial artery was removed after antibiotic treatment.The pseudoaneurysm of the right SFA rapidly expanded after admission,but the expansion rate was reduced after infection control.Seven months after the first admission,the pseudoaneurysm of the left SFA was re-moved and in situ revascularization performed using a rifampicin-soaked Dacron graft.CONCLUSION Although pseudoaneurysm after DES placement in the lower extremity region is rare,it must be considered in patients with bacteremia.
文摘[Objectives] To investigate the clinical efficacy of Chaihu Shugan Powder on chronic superficial gastritis with liver-stomach disharmony syndrome.[Methods] A total of 72 patients diagnosed with chronic superficial gastritis characterized by liver-stomach disharmony syndrome between September 2023 and August 2024 were randomly assigned into two groups. The control group received treatment with western medicine, and the treatment group was administered both western medicine and Chaihu Shugan Powder. The therapeutic effects, TCM syndrome scores, adverse reactions, and recurrence rate were compared between the two groups.[Results] The total effective rate was 88.89% in the treatment group and 80.56% in the control group. The differences between the two groups were statistically significant ( P <0.05), indicating that the improvement observed in the treatment group was significantly greater than that in the control group ( P <0.05). In comparison to pre-treatment levels, the TCM syndrome scores for both patient groups exhibited a reduction following treatment. Notably, the extent of this reduction in the treatment group was significantly greater than that observed in the control group ( P <0.05). Neither group of patients experienced serious adverse reactions during treatment. Furthermore, the recurrence rate among patients in the control group was found to be higher than that in the treatment group.[Conclusions] The clinical efficacy of Chaihu Shugan Powder in the treatment of chronic superficial gastritis with liver-stomach disharmony syndrome is significant, demonstrating a notable reduction in the recurrence rate of the condition.
文摘Superficial serrated adenoma (SuSA) is a new subtype of serrated lesions proposed in recent years, most of which are located in the sigmoid colon or rectum, with typical mixed adenoma and serrated pathological features, and its molecular features are high frequency of KRAS mutation and RSPO fusion or overexpression. At present, it is believed that SuSA has two subtypes: traditional serrated adenoma (TSA)-associated SuSA and isolated SuSA. Solitary SuSA showed faded pedicle-free protuberant lesions under endoscope and lobulated, pp (pit pattern) classification was type II and type IIIH, TSA-associated SuSA showed double-layer eminence, SuSA part showed white flat eminence, pp classification showed type II and IIIH, TSA part showed red tone high eminence, pp was IVH type. SuSA can develop into colorectal cancer through the evolution of TSA, and it can also directly develop into MSS colorectal cancer. In view of the superficial understanding of SuSA and the lack of a complete description of SuSA, this paper review the research progress of SuSA at home and abroad from the origin, endoscope features, histopathological features, molecular biology, differential diagnosis and treatment of SuSA, in order to better promote the understanding and clinical diagnosis of lesions.
文摘Purpose: To evaluate optical coherence tomography angiography (OCT-A) data obtained from the superficial retinal capillary plexus of patients with retinal vein occlusion and comparative analysis with data registered from unaffected fellow eyes. Methods: The examined patients were classified into 2 groups: group 1—eyes with established retinal vein occlusion (n = 29) and group 2—unaffected fellow eyes of patients with retinal vein occlusion (n = 24). The scanning protocol “Angiography 3 × 3 mm” of Zeiss Cirrus HD-OCT 6000, AngioPlex Metrix was used to evaluate the retinal superficial capillary plexus. The analyzed parameters were vascular density and perfusion density, as well as the area, perimeter, and circularity of the foveolar avascular zone (FAZ). Results: The comparative analysis of FAZ parameters at the superficial capillary plexus (SCP) between group 1 (eyes with retinal vein occlusion) and group 2 (unaffected fellow eyes) showed significant results for the three parameters, respectively area (p = 0.003), perimeter (p ≤ 0.001), and circularity (p = 0.011) of FAZ. The comparative analysis of the vascular network at SCP in patients with diagnosed retinal vein occlusion and unaffected fellow eyes showed significant results for vascular density (VD) in the central (p = 0.038) and inner (p ≤ 0.001) zones as well as total VD (p ≤ 0.001) were statistically significant. Moreover, the results obtained in the study of vascular perfusion (VP) indicated significant results in the inner zone (p ≤ 0.001) and total VP (p = 0.001). Vascular perfusion in the central zone (p = 0.116) was the only parameter not to meet significant results. Conclusion: The current study observed a significant enlargement of the FAZ and loss of its circularity, along with a reduction in vascular network parameters at the superficial retinal capillary plexus level.
基金Supported by State Administration of Traditional Chinese Medicine of the People’s Republic of China "Twelfth FiveYear Plan" key specialty construction projectMajor scientific project of Changning District Science and Technology Commission:CNKW2013Z05+1 种基金Traditional Chinese medicine scientific research fund project of Shanghai Municipal Commission of Health and Family Planning:2014LQ021ATCM of Shanghai style heritage research base project of Shanghai Municipal Health Bureau:ZYSNXD-CCHPGC-JD-004
文摘Objective To observe the correlation between analgesic effect and duration of analgesic effect of superficial needling for shoulder pain of shoulderhand syndrome（SHS） after stroke, so as to screen the best time period of analgesia. Methods A total of 120 patients with SHS after stroke（stage I） were recruited and superficial needling therapy was applied. Two obvious tenderness points on the affected shoulder of patients were found out. The site 80–100 mm down each tenderness point was selected for superficial needling. Bimanual needling technique was applied after inserting needles. The surrounding of tenderness points was pinched and grasped by left hand above the needling, and the technique of green dragon swaying tail was applied by right hand. The needles at each acupoint were manipulated for3 min and retained for 30 min. The analgesic effect was evaluated dynamically by visual analogue scale（VAS） in 120 patients before treatment, immediately after treatment, 30 min after treatment, 1 h after treatment and 24 h after treatment. The analgesic effects at different time were statistically analyzed by generalized estimating equation. Results The mean values of VAS were 7.483, 3.950, 4.767, 5.917 and 7.217, respectively, before treatment, immediately after treatment, 30 min after treatment, 1 h after treatment and 24 h after treatment. The difference of analgesic effect at different time was statistically significant（P〈0.01）; the difference of analgesic effect of superficial needling in treatment of SHS after stroke was significant between immediately after treatment and 30 min after treatment（both P〈0.05）, while there was no significant difference between 1 h after treatment and 24 h after treatment（both P〈0.05）. Conclusion Analgesic effect of superficial needling for shoulder pain of SHS after stroke was different at different time points and decreased over time; analgesic effect was the most significant immediately after treatment and the optimal duration of analgesic effect was from immediately to 30 min after superficial needling therapy.
文摘In the present study, we aimed to evaluate the efficiency and cost ofpirarubicin （THP） and epirubicin （EPI） as prophylaxis for recurrence in patients with superficial bladder tumors by bladder instillation after transurethral resection of a bladder tumor （TUR-BT）. Standardized evaluation was performed by analyzing research papers. Moreover, expert opinions, studies and cost data were combined to evaluate cost of THP and EPI. With systematic review and expert opinions, we confirmed that THP and EPI were not statistically different when they were used as prophylaxis for recurrence in patients with superficial bladder tumors by bladder instillation after TUR-BT. Moreover, the cost evaluation of THP and EPI needs to be separately discussed according to original/generic drug. The original drug THP had more cost advantages than EPI, while generic EPI had more cost advantages than THP.
基金Supported by The National Council on Science and Technology (CONACYT:85675 and 79628)Institute of Public Health(POA: 2008-2010)Research Office of Veracruzana University and Public Education Secretariat(SEP-PROMEP-UV:PTC-319)
文摘AIM:To assess expression of matrix metalloproteinases 2(MMP2)and MMP9 in gastric cancer,superficial gastritis and normal mucosa,and to measure metalloproteinase activity.METHODS:MMP2 and MMP9 mRNA expression was determined by quantitative real-time polymerase chain reaction.Normalization was carried out using three different factors.Proteins were analyzed by quantitative gelatin zymography(qGZ).RESULTS:18S ribosomal RNA(18SRNA)was very highly expressed,while hypoxanthine ribosyltransferase-1(HPRT-1)was moderately expressed.MMP2 was highly expressed,while MMP9 was not detected or lowly expressed in normal tissues,moderately or highly expressed in gastritis and highly expressed in cancer.Relative expression of 18SRNA and HPRT-1 showed no significant differences.Significant differences in MMP2 and MMP9 were found between cancer and normal tissue,but not between gastritis and normal tissue.Absolute quantification of MMP9 echoed this pattern,but differential expression of MMP2 proved conflictive.Analysis by qGZ indicated significant differences between cancer and normal tissue in MMP-2,total MMP-9,250 and 110 kDa bands.CONCLUSION:MMP9 expression is enhanced in gastric cancer compared to normal mucosa;interpretation of differential expression of MMP2 is difficult to establish.
文摘AIM: To investigate the effectiveness of endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) in treating superficial esophageal cancer (SEC).
基金Supported by the Science and Technology Department of Sichuan Province for Scientific Research,No.2015SZ0123
文摘AIM To evaluate the clinical outcomes of patients who underwent endoscopic submucosal tunnel dissection(ESTD) for esophageal squamous cell carcinoma(ESCC) and precancerous lesions.METHODS ESTD was performed in 289 patients. The clinical outcomes of the patients and pathological features of the lesions were retrospectively reviewed.RESULTS A total of 311 lesions were included in the analysis. The en bloc rate, complete resection rate, and curative resection rate were 99.04%, 81.28%, and 78.46%, respectively. The ESTD procedure time was 102.4 ± 35.1 min, the mean hospitalization time was 10.3 ± 2.8 d, and the average expenditure was 3766.5 ± 846.5 dollars. The intraoperative bleeding rate was 6.43%, the postoperative bleeding rate was 1.61%, the perforation rate was 1.93%, and the postoperative infection rate was 9.65%. Esophageal stricture and positive margin were severe adverse events, with an incidence rate of 14.79% and 15.76%, respectively. No tumor recurrence occurred during the follow-up period. CONCLUSION ESTD for ESCC and precancerous lesions is feasible and relatively safe, but for large mucosal lesions, the rate of esophageal stricture and positive margin is high.
基金supported by the emarked fund for the China Agriculture Research System for National Technology System for Pear Industry(CARS-28-22)the Innovation Project of Modern Agricultural Sciences and Technology of Hebei Province,China(494-0402-YSN-C8RA)+1 种基金the Youth Fund of Hebei Academy of Agriculture and Forestry Sciences,China(A2015110106)the Finance Special Foundation of Hebei Province,China(494-0402-YBN-0G4L)
文摘The Yali pear（Pyrus bretschneideri Rehd.） is susceptible to superficial scald during prolonged cold storage and at shelf life. This study investigated the effects of 1-methylcyclopropene（1-MCP） and modified atmosphere packaging（MAP） on changes of fruit quality and superficial scald during cold storage and at shelf life in Yali pear. Compared with MAP, the combination of MAP and 1-MCP（MAP＋1-MCP） treatment reduced the carbon dioxide and ethylene content inside the packaging bag. The 1-MCP, MAP, and MAP＋1-MCP treatments reduced the superficial scald index, malondialdehyde content, O2^-· production rate and relative conductivity and inhibited the accumulation of α-farnesene and conjugated trienes in the peel. 1-MCP and MAP＋1-MCP treatments maintained a higher phenolic content and enhanced the catalase and superoxide dismutase activities in the fruit, while reduced activities of lipoxygenase and polyphenol oxidase in the peel preceding the onset of superficial scald. Comprehensive analysis indicated that the MAP＋1-MCP treatment is the most effective method tested for improving the quality of Yali pears during cold storage and at shelf life.
文摘Therapeutic endoscopy plays a major role in the management of gastrointestinal (GI) neoplasia. Its indications can be generalized into four broad categories; to remove or obliterate neoplastic lesion, to palliate malignant obstruction, or to treat bleeding. Only endoscopic resection allows complete histological staging of the cancer, which is critical as it allows stratification and refinement for further treatment. Although other endoscopic techniques, such as ablation therapy, may also cure early GI cancer, they can not provide a definitive pathological specimen. Early stage lesions reveal low frequency of lymph node metastasis which allows for less invasive treatments and thereby improving the quality of life when compared to surgery. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are now accepted worldwide as treatment modalities for early cancers of the GI tract.
基金funded by the National Natural Science Foundation of China (Grant Nos.: 81903426 and 81803347)
文摘Chronic superficial gastritis(CSG)is a common disease of the digestive system that possesses a serious pathogenesis.Jinhong tablet(JHT),a traditional Chinese medicine(TCM)prescription,exerts therapeutic effects against CSG.However,the molecular basis of its therapeutic effect has not been clarified.Herein,we employed ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry(UPLC-Q/TOF-MS)based chemical profile identification to determine the chemical components in JHT.Further,we applied network pharmacology to illustrate its molecular mechanisms.A total of 96 chemical constituents were identified in JHT,31 of which were confirmed using reference standards.Based on the bioinformatics analysis using the symptom-guided pharmacological networks of“chi,”“blood,”“pain,”and“inflammation,”and target screening through the interaction probabilities between compounds and targets,matrix metalloproteinase 2(MMP2),dopamine d2 receptor(DRD2),and Aldo-keto reductase family 1 member B1(AKR1B1)were identified as key targets in the therapeutic effect exhibited by JHT against CSG.Moreover,according to the inhibitory activities presented in the literature and binding mode analysis,the structural types of alkaloids,flavonoids,organic acids,including chlorogenic acid(10),caffeic acid(13),(-)-corydalmine(33),(-)-isocorypalmine(36),isochlorogenic acid C(38),isochlorogenic acid A(41),quercetin-3-O-a-L-rhamnoside(42),isochlorogenic acid B(47),quercetin(63),and kaempferol(70)tended to show remarkable activities against CSG.Owing to the above findings,we systematically identified the chemical components of JHT and revealed its molecular mechanisms based on the symptoms associated with CSG.
文摘AIM To simplify the diagnostic criteria for superficial esophageal squamous cell carcinoma(SESCC) on Narrow Band Imaging combined with magnifying endoscopy(NBI-ME).METHODS This study was based on the post-hoc analysis of a randomized controlled trial. We performed NBI-ME for 147 patients with present or a history of squamous cell carcinoma in the head and neck, or esophagus between January 2009 and June 2011. Two expert endoscopistsdetected 89 lesions that were suspicious for SESCC lesions, which had been prospectively evaluated for the following 6 NBI-ME findings in real time: "intervascular background coloration"; "proliferation of intrapapillary capillary loops(IPCL)"; and "dilation", "tortuosity", "change in caliber", and "various shapes(VS)" of IPCLs(i.e., Inoue's tetrad criteria). The histologic examination of specimens was defined as the gold standard for diagnosis. A stepwise logistic regression analysis was used to identify candidates for the simplified criteria from among the 6 NBI-ME findings for diagnosing SESCCs. We evaluated diagnostic performance of the simplified criteria compared with that of Inoue's criteria.RESULTS Fifty-four lesions(65%) were histologically diagnosed as SESCCs and the others as low-grade intraepithelial neoplasia or inflammation. In the univariate analysis, proliferation, tortuosity, change in caliber, and VS were significantly associated with SESCC(P < 0.01). The combination of VS and proliferation was statistically extracted from the 6 NBI-ME findings by using the stepwise logistic regression model. We defined the combination of VS and proliferation as simplified dyad criteria for SESCC. The areas under the curve of the simplified dyad criteria and Inoue's tetrad criteria were 0.70 and 0.73, respectively. No significant difference was shown between them. The sensitivity, specificity, and accuracy of diagnosis for SESCC were 77.8%, 57.1%, 69.7% and 51.9%, 80.0%, 62.9% for the simplified dyad criteria and Inoue's tetrad criteria, respectively.CONCLUSION The combination of proliferation and VS may serve as simplified criteria for the diagnosis of SESCC using NBIME.
基金supported by the Medicine and Health,Science and Technology Plan Project of Zhejiang(2020KY1009).
文摘Objective To evaluate the gastric microbiome in patients with chronic superficial gastritis(CSG)and intestinal metaplasia(IM)and investigate the influence of Helicobacter pylori(H.pylori)on the gastric microbiome.Methods Gastric mucosa tissue samples were collected from 54 patients with CSG and IM,and the patients were classified into the following four groups based on the state of H.pylori infection and histology:H.pylori-negative CSG(n=24),H.pylori-positive CSG(n=14),H.pylori-negative IM(n=11),and H.pylori-positive IM(n=5).The gastric microbiome was analyzed by 16S rRNA gene sequencing.Results H.pylori strongly influenced the bacterial abundance and diversity regardless of CSG and IM.In H.pylori-positive subjects,the bacterial abundance and diversity were significantly lower than in H.pylori-negative subjects.The H.pylori-negative groups had similar bacterial composition and bacterial abundance.The H.pylori-positive groups also had similar bacterial composition but different bacterial relative abundance.The relative abundance of Neisseria,Streptococcus,Rothia,and Veillonella were richer in the I-HP group than in G-HP group,especially Neisseria(t=175.1,P<0.001).Conclusions The gastric microbial abundance and diversity are lower in H.pylori-infected patients regardless of CSG and IM.Compared to H.pylori-positive CSG group and H.pylori-positive IM,the relative abundance of Neisseria,Streptococcus,Rothia,and Veillonella is higher in H.pylori-positive patients with IM than in H.pylori-positive patients with CSG,especially Neisseria.
文摘The diagnostic and treatment guidelines of superficial non-ampullary duodenal tumors have not been standardized due to their low prevalence.Previous reports suggested that a superficial adenocarcinoma(SAC) should be treated via local resection because of its low risk of lymph node metastasis,whereas a highgrade adenoma(HGA) should be resected because of its high risk of progression to adenocarcinoma.Therefore,pretreatment diagnosis of SAC or HGA is important to determine the appropriate treatment strategy.There are certain endoscopic features known to be associated with SAC or HGA,and current practice prioritizes the endoscopic and biopsy diagnosis of these conditions.Surgical treatment of these duodenal lesions is often related to high risk of morbidity,and therefore endoscopic resection has become increasingly common in recent years.Endoscopic mucosal resection(EMR) and endoscopic submucosal dissection(ESD) are the commonly performed endoscopic resection methods.EMR is preferred due to its lower risk of adverse events;however,it has a higher risk of recurrence than ESD.Recently,a new and safer endoscopic procedure that reduces adverse events from EMR or ESD has been reported.
文摘BACKGROUND Adverse events during endoscopic submucosal dissection(ESD)of superficial esophageal neoplasms,such as perforation and bleeding,have been welldocumented.However,the Mallory-Weiss Tear(MWT)during esophageal ESD remains under investigation.AIM To investigate the incidence and risk factors of the MWT during esophageal ESD.METHODS From June 2014 to July 2017,patients with superficial esophageal neoplasms who received ESD in our institution were retrospectively analyzed.The clinicopathological characteristics of the patients were collected.Patients were divided into an MWT group and non-MWT group based on whether MWT occurred during ESD.The incidence of MWTs was determined,and the risk factors for MWT were then further explored.RESULTS A total of 337 patients with 373 lesions treated by ESD were analyzed.Twenty patients developed MWTs during ESD(5.4%).Multivariate analysis identified that female sex(OR=5.36,95%CI:1.47-19.50,P=0.011)and procedure time longer than 88.5 min(OR=3.953,95%CI:1.497-10.417,P=0.005)were independent risk factors for an MWT during ESD.The cutoff value of the procedure time for an MWT was 88.5 min(sensitivity,65.0%;specificity,70.8%).Seven of the MWT patients received endoscopic hemostasis.All patients recovered satisfactorily without surgery for the laceration.CONCLUSION The incidence of MWTs during esophageal ESD was much higher than expected.Although most cases have a benign course,fatal conditions may occur.We recommend inspection of the stomach during and after the ESD procedure for timely management in cases of bleeding MWTs or even perforation outside of the procedure region.
基金Key Projects of Natural Science Research in Colleges and University of Anhui Province,No.2017A236.
文摘BACKGROUND Superficial CD34-positive fibroblastoma(SCPFT)is a newly discovered mesenchymal tumor characterized by high polymorphism,low mitotic rate,and diffuse CD34-positive reactions.AIM To further determine the clinicopathological features of SCPFT.METHODS We retrospectively analyzed the clinicopathological data,immunohistochemistry results,and differential diagnoses of four patients with SCPFT and performed a literature review.Relevant fusion genes were also detected.RESULTS The tumors were all located in the lower extremities and presented as slowgrowing painless masses located in the dermis and subcutaneous tissue.Microscopically,the tumors were composed of spindle-shaped to epithelioid cells with scattered abnormal and pleomorphic nuclei on a fibrous or fibromyxoid background.Necrosis was not found in the tumor tissues,and mitotic figures were rare.Immunohistochemically,the tumor cells were strongly positive for vimentin and CD34,and CKpan showed focal positivity in two tumors.All four patients were followed(13-57 mo,mean 35 mo),and one patient experienced local recurrence.CONCLUSION SCPFT is a newly discovered borderline mesenchymal tumor that can locally recur or even metastasize.Familiarity with its clinicopathological features will help avoid confusion with skin mesenchymal tumors with similar features.
