ABSTRACT
Clinical data of 62 patients with gastrointestinal submucosal tumors (diameter ≥1 cm) who were treated with kissing suture by single-channel endoscope after endoscopic full-thickness resection (EFR) in the First Affiliated Hospital of Zhengzhou University from February 2017 to May 2019 were analyzed retrospectively to evaluate the clinical value of kissing suture technique by single-channel endoscope in defect closure after EFR. All the post-EFR defects were successfully closed (100%). No postoperative anastomotic leakage or other serious complications occurred. The mean maximum diameter of lesions was 3 cm (ranged 1-7 cm), and 13 (21%) of them were greater than or equal to 5 cm.The mean number of clips used was 25.7 (ranged 7-78). The mean procedure time was 168 min (ranged 44-300 min), and the mean suture time was 63 min (ranged 13-211 min). The mean postoperative hospital stay was 7 days (ranged 4-12 days). Endoscopic reexamination 3-6 months after operation showed that all wounds healed well. Kissing suture method by single-channel endoscope is a safe, effective, easy and feasible for closing gastrointestinal defect after EFR.
ABSTRACT
Objective:To study the safety and effectiveness of endoscopic full-thickness resection(EFR) in the treatment of large gastric stromal tumors with diameter of 5-7 cm.Methods:Data of 36 patients with large gastric stromal tumors (5-7 cm) who received EFR or surgery (including laparoscopic and open surgery) in the First Affiliated Hospital of Zhengzhou University and confirmed by postoperative histopathology from January 2017 to October 2018 were retrospectively analyzed. Patients were divided into endoscopic group (9 cases) and surgical group (27 cases) according to different resection methods. The perioperative indicators and the total incidence of complications in the two groups were compared.Results:In terms of perioperative indicators, the median operation time of the endoscopic group was significantly longer than that of the surgical group (4.0 hours VS 2.0 hours, P<0.01), and the postoperative fasting time (4.55±0.88 days VS 6.22±2.24 days, t=-2.15, P=0.03) and hospital stay (6.88±1.26 days VS 10.03±2.90 days, t=-3.13, P<0.01) were significantly shorter than those of the surgical group. The median visual analogue scores (VAS) of abdominal pain of the endoscopic group on the first postoperative day (3 VS 6, P<0.01)and the third postoperative day (1 VS 3, P<0.01) were significantly lower than those of the surgical group. The hospitalization cost was significantly less than that of the surgical group (55±14.7 thousand yuan VS 73±24.3 thousand yuan, t=-2.11, P=0.04). In term of the total incidence of complications, the endoscopic group was 11.1% (1/9), which was higher than that of the surgical group [7.4% (2/27)], but there was no statistically significant difference( P=1.00). Conclusion:EFR is safe and effective in the treatment of large gastric stromal tumors (5-7 cm), and has the advantages of less invasiveness, rapid postoperative recovery, and lower hospitalization cost. But how to shorten the operation time is an urgent problem to be solved.
ABSTRACT
From June 2017 to September 2019, 5 patients who were diagnosed as having benign severe pyloric stenosis underwent fully covered stent placement using a new stenting method at the First Affiliated Hospital of Zhengzhou University. Five patients were performed successfully without serious complications. Postoperative barium meal radiograph revealed that the stents were in good location and the acontrast agent passed smoothly. The liquid diet was commenced 1-3 days after surgery. No vomiting, abdominal pain and diarrhea occurred. During the follow-up, all the patients had improved weight and nutritional status. Four patients underwent stent removal 3-4 months postoperatively. One patient was found that the stent had migrated to stomach 3 months after discharge. After removing the stent, balloon dilation and mucosal resection was performed for the mild pyloric stenosis. All 5 patients had an additional follow-up of 3 months, and no symptoms and restenosis occured. These preliminary results showed that the new stenting method of fully covered stent placement is feasible, safe and effective in the treatment of benign pyloric stenosis.
ABSTRACT
To date,the clustered regularly interspaced short palindromic repeat (CRISPR)/Cas9 system has been widely used to edit the genome in many species and cells.The system is the third generation of artificial endonuclease,which can edit DNA by recognizing short DNA sequences.This paper reviews the structural features of the system and its application in virus research,such as the functional studies of virus-related genes and the exploration of antiviral therapies (including HIV,HBV,and EB virus),looking forward to the future direc-tion of virus research.
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Objective To study the expression of p27kip1 and Ki67 proteins in various types of gastric polyp and the relationship be-tween gastric polyp and gastric carcinoma (CA:). Methods The expression of p27kip1 and Ki67 proteins were detected in normal gastric mu-cosa, hyperplasie polyp, adenomatons polyp, and carcinoma by S-P immunohistochemical staining. Results In the normal gastric mucosa,hyperplasie polyp, adenomatous polyp and gastric carcinoma, the expression rate of the p27kip1 protein was 90. 00% ,70. 00% ,65.00% and 30. 43%, respectively. The positive rate of p27kip1 protein in gastric cancer was significantly lower than that in other tissues. The rate of Ki67 protein expression in those tissues was 10. 00%, 15.00%, 45.00%, and 73.33%, respectively. The positive rate of Ki67 protein in gastric cancer was significantly higher than that in other tissues. And the positive rate of Ki67 in adenomatous polyp was significantly higher than that in the normal gnstric mucosa and hyperplasic polyp. There were significant differences among them(P <0.05). There was no correlation between the expression of p27kip1 and Ki67 proteins in gastric polyp(rs=-0. 093, P >0. 05). Conclusion Detection of p27kip1 and Ki67 proteins in gastric polyp was very helpful in early diagnosis and prognosis of GC.