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Objective:To evaluate the long-term efficacy of endoscopic submucosal dissection (ESD) and surgical resection on the treatment of early esophagogastric junction (EGJ) adenocarcinoma.Methods:A retrospective analysis was performed on the data of 166 consecutive cases with early EGJ adenocarcinoma in Digestive Endoscopy Center and Department of General Surgery of Shanxi Provincial People′s Hospital from January 2004 to June 2018. Their preoperative assessment conformed to the absolute and expanded criteria of ESD, and postoperative pathological assessment accorded with the absolute and expanded criteria of curative resection. Patients were divided into the ESD group (n=77) and the surgical resection group (n=89), and the recent results (curative resection rate and complications) and long-term results (cumulative survival rate) were compared between the two groups.Results:In the ESD group, 65 (84.4%) patients met the absolute criteria of ESD treatment and 12 (15.6%) patients met the expanded criteria. In the surgical resection group, 60 (67.4%) patients met the absolute criteria of ESD and 29 (32.6%) patients met the expanded criteria. The difference in the composition of ESD criteria was statistically significant between the two groups ( P=0.011). Other baseline indicators showed no significant difference between the two groups ( P > 0.05). In the ESD group, the overall resection rate was 98.7% (76/77), the complete resection rate was 94.8% (73/77), and the curative resection rate was 93.5% (72/77). In the surgical resection group, the curative resection rate was 100.0% (89/89). The difference in the curative resection rate between the two groups was not statistically significant ( P=0.05). In the ESD group, there were 3 (3.9%) cases of intraoperative bleeding, 1 (1.3%) case of early postoperative bleeding, and 2 (2.6%) cases of intraoperative perforation. In the surgical resection group, there was 1 (1.1%) case of intraoperative bleeding, 4 (4.5%) cases of postoperative bleeding, and 2 (2.2%) cases of postoperative anastomotic leakage. There was no death or local recurrence occurred in the both groups within 1 month after treatment. The median follow-up time was 89.3 months (ranged 72.5-105.7 months) in the ESD group and 82.3 months (ranged 69.6-101.0 months) in the surgical treatment group, respectively. There was no tumor-related death or recurrence occurred in the two groups during follow-up. The 5-year survival rate in the ESD group and the surgical resection group was 94.8% (73/77) and 96.6% (86/89), respectively. The difference in the cumulative survival rate was not significant between the two groups ( P=0.648). Subgroup analysis showed that there was no significant difference in the cumulative survival rate between patients receiving ESD and those receiving surgical resection who met the absolute criteria of ESD ( P=0.449) and met ESD expanded criteria ( P=0.505). Conclusion:For EGJ adenocarcinoma conforming to the ESD treatment absolute and expanded criteria, ESD may be an alternative treatment option to surgery with the comparable long-term outcomes.
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Locoweeds are presently defined as those species of the genera Oxytropis and Astragalus (family Leguminosae) that specifically contain the key toxic constituent,swainsonine.After ingesting locoweeds,livestock can develop poisoning disease characterized by chronic dysfunction of the nervous system,which causes severe economic losses to the pastoral areas.In addition,swainsonine has attracted a great attention from toxicology and medicine fields,due to its dual role of toxicity and pharmacological activity.This review not only summarizes the latest research progress of toxicity and its poisoning mechanism,pharmacological activity,source,and biosynthesis pathway of swainsonine,but also speculates the possible regulatory enzymes involved in the synthesis pathway.Moreover,the future research on swainsonine is also looked ahead,which provide references for the prevention and treatment of locoism.
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Bones are stained into red color with feeding madder, but we do not know whether the fed madder can change the bone biomechanical properties and bone mineral contents in animals. In this research, we established a rat model with feeding madder. The bone biomechanical properties were detected by universal material mechanics, bone mineral contents were detected by inductively coupled plasma mass spectrometry and spectrometer, and red color material in bone was analyzed by high performance liquid chromatography. The results showed that bone biomechanical parameters in femur diaphysis in the 10% and 15% group rats were significantly higher than those in the control group after feeding madder for 6 months. The level of calcium, magnesium and zinc in femur diaphysis in 10% and 15% group rats were higher than those in the control group after feeding madder for 6 months. However, it was shown that the kidney congestion and hyperemia and the level of blood urea nitrogen and creatinine in the 15% group rats were significantly different compared to those in the control group rats after feeding madder for 6 months. The red colored material in bone is related to alizarin analyzed with high-performance liquid chromatography. The conclusion could be drawn that feeding 10% madder in diet was not toxic to the rats fed for 6 months, and it could improve bone biomechanical properties and increase bone mineral elements.
Subject(s)
Animals , Rats , Anthraquinones , Toxicity , Biomechanical Phenomena , Bone Density , Bone and Bones , Physiology , Calcium , Femur , Magnesium , ZincABSTRACT
Objective To observe the effect of acupoint-injection on vascular dementia. Methods 1 ml of cytidine diphosphocholine was injected into Baihui ( GV 20) and Fengchi (GB 20, bilateral) respectively. 234 patients were treated. Results and conclusion: 49 cases were cured, 150 cases got improve, 35 cases had ineffectiveness, the total utility rate was 85.0%, so acupoint-injecting cytidine diphosphocholine is a utility method healing vascular dementia.