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Objective@#To compare the feasibility and efficacy of attempted underwater endoscopic mucosal resection(EMR) with conventional EMR for colorectal sessile or flat tumors.@*Methods@#A total of 120 colorectal tumors of 5 to 30 mm in size were removed using underwater EMR or conventional EMR. En bloc resection rates of the two groups were retrospectively analyzed.@*Results@#Underwater EMR was performed on 53 colorectal sessile/flat tumors with the median size of 22 mm, and conventional EMR was performed on 67 tumors of the same median size. The overall en bloc resection rate of the underwater EMR group was higher than that of the conventional EMR group(81.1% VS 59.7%, P=0.012). The subgroup analysis showed en bloc resection rates of Paris 0-Ⅱa tumor (76.7% VS 50.0%, P=0.035) and those located at the inaccessible regions (100.0% VS 42.9%, P=0.004) were higher than that of conventional EMR. Neither postoperative bleeding nor perforation occurred in the two groups. Residual adenoma was found in 1 patient in underwater EMR group and 2 in the conventional EMR group, respectively(P=0.712).@*Conclusion@#Underwater EMR with prior submucosal injection appears superior to conventional EMR for the removal of colorectal sessile or flat Paris 0-Ⅰs/Ⅱa tumors of less than 3 cm in size in the rate of complete endoscopic resection and defect closure.
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Objective To evaluate the effect of indomethacin in the prevention of post ERCP pancreatitis (PEP) .Methods The literatures and corresponding references of randomized controlled trials (RCT ) on indomethacin in the prevention of PEP were searched from Cochrane Library (Jan 1970 to June 2013) ,Pubmed(Jan 1966 to June 2013) ,EMBASE(Jan 1966 to June 2013)and China Biology Medicine disc(Jan 1978 to June 2013) .Literature screening ,data extraction and methodological quality assessment were individually performed by two researchers .The software RevMan 5 .2 of Cochrane Collaboration was used for statistical analy‐sis .Results A total of 7 trails ,2170 patients were included in this study .Meta analysis results showed:indomethacin could effec‐tively prevent from PEP (RR=0 .45 ,95% CI:0 .33-0 .60 ,P<0 .05) and Hyperamylasemia (RR=0 .51 ,95% CI:0 .37-0 .70 ,P<0 .05) compared with placebo ,and could effectively alleviate the severity of pancreatitis after ERCP (RR=0 .43 ,95% CI:0 .23 -0 .78 ,P<0 .05) .Conclusion Indomethacin could effectively prevent from PEP and Hyperamylasemia ,and could effectively alleviate the severity of PEP .
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Objective To explore the occurrence of anemia, anaemia type, iron metabolism situation,variation of serum Prealbumin (PA), and the relationship among them in cancer patients. Methods Three hundred and seventy cancer patients, admitted from July 2007 to April 2010 to our hospital, were enrolled into the study. The clinical data of all subjects were analyzed retrospectively. Results The incidence of anemia in 370 patients was 55.67% (206/370). Among all 206 anemia cases,129 cases had mild anaemia and 77 cases had middle to severe anaemia. In the last group ( n = 77 ), we found significant decrease in serum iron level ( [ 8. 37 ± 6. 09 ] μmol/L) and increase in serum ferritin level ( [ 474. 57 ± 327. 58 ] μg/L); and the correlation between serum iron and the anemia degree( Ps ＜ 0. 05 ). However, we found no significant differences of serum ferritin level between the groups with different degree of anemia(P ＞0. 05). Among all 206 anemia cases ,187(90. 77% ) patients had a low level of serum PA, but no relationship between the degree of anemia and the drop of serum PA ( P ＞ 0. 05 ). Conclusion The anemia was very popular in cancer patients, which had correlation with iron metabolism situation but not PA.