ABSTRACT
To investigate the efficacy and safety of modified endoscopic retrograde appendicitis therapy (ERAT) in children with acute uncomplicated appendicitis complicated with intussusception. Data of 6 patients with acute uncomplicated appendicitis complicated with intussusception who received modified ERAT were collected from October 2018 to February 2020 in Pediatrics Department of Tangdu Hospital. The reduction rate of intussusception, the success rate of ERAT appendiceal intubation and endoscopic treatment, the remission time of clinical symptoms, the time of white blood cells return to normal, the length of hospital stay, complications and recurrence were summarized. All the 6 patients were confirmed to be acute uncomplicated appendicitis combined with ileocecal intussusceptions under colonoscopy. Endoscopic intussusception reduction and ERAT were performed successfully. The mean time of disappearance of abdominal tenderness was 1.3 days after the therapy, and the time of white blood cells return to normal was 1 day after surgery. The endoscopic treatment were all successful and the length of hospital stay was 3-6 days. No complications or recurrence of intussusception and appendicitis occurred during the follow-up period of 6-12 months. Modified ERAT can effectively, safely and minimally invitingly treat acute uncomplicated appendicitis with intussusception in children on the basis of definite diagnosis.
ABSTRACT
Objective:To study the value of ultrasound-guided endoscopic retrograde appendicitis therapy in children with uncomplicated appendicitis.Methods:This study was a single center, retrospective study, including all electronic cases of appendicitis diagnosed clinically in Department of Pediatrics, the Second Affiliated Hospital of Air Force Military Medical University from October 2018 to October 2020 and received ultrasound-guided endoscopic retrograde appendicitis therapy.The clinical features, treatment and prognosis of the children were retrospectively analyzed.Results:A total of 152 electronic cases were included, there were 77 males and 75 females, aged(6.84±3.09) years.All the 152 children were treated with ultrasound-guided endoscopic retrograde appendicitis therapy.Intubation success rate and clinical success rate was 98.03%(149/152 cases)and 97.99%(146/149 cases), respectively.The median time of endoscopic therapy was 42.50 (31.00, 56.00) minutes.Mean postoperative hospital stay was (2.81 ±1.41) days, and the mean total hospital stay was (4.19 ±1.71) days.A total of 139 patients were followed up with a median follow-up time of 5 (1, 26) months.During the follow-up, the recurrence rate was 7.19%(10/139 cases), and the median time of recurrence was 2 (1, 3) months.Conclusions:Ultrasound-guided endoscopic retrograde appendicitis therapy had high effective rate and low recurrence rate in children with uncomplicated appendicitis, preserved the physiological function of appendix and avoided radiation damage.It can be used as a safe and effective treatment for acute and chronic uncomplicated appendicitis in children.
ABSTRACT
Objective To investigate the effect of antibiotic-induced microbiota dysbiosis on colonic barrier and immune response in juvenile mice.Methods Twenty Balb/c mice were randomly divided into experimental group and control group.Broad spectrum antibiotic mixture were administered by means of gavage to the experimental group every 12 hours for 14 days to induce intestinal microbiota dysbiosis.The mice of control group were given an equal amount of physiological saline.On the 15th day,all mice were intraperitoneally injected with lipopolysaccharide(LPS) to induce intestinal inflammatory reaction.The structure of intestinal flora was analyzed by way of 16SrRNA sequencing,and the morphology of colonic mucosa was observed by means of HE staining.The infiltration of colonic mucosa was observed through toluidine blue staining and immunohistochemistry.The levels of inflammatory cytokines in colon tissue were measured by real-time PCR and intestinal permeability-related parameters were measured by enzyme-linked immunosorbent assay.Results The intestinal microbial composition of the experimental group was significantly changed,and the expression levels of inflammatory cytokines interleukin (IL)-1β,IL-6,IL-8,IL-10,tumor necrosis factor (TNF)-α mRNA in the antibiotic group (0.765 ± 0.062,0.082 ± 0.040,0.442 ± 0.059,0.469 ±0.079,0.736 ± 0.063) were all lower than those in the control group (1.738 ± 0.243,1.090 ± 0.104,1.151 ±0.136,1.066 ± 0.102,1.539 ± 0.218),and the differences were statistically significant (all P ＜ 0.05).The expressions of intestinal barrier related gene of mice ZO-1 and Occludin decreased (0.639 ± 0.071 vs.1.347 ± 0.224,0.770 ±0.067 vs.1.487 ± 0.148) but the level of fecal albumin increased [(6.419 ± 0.552) mg/L vs.(6.079 ± 0.011) mg/L] after antibiotic exposure,and the differences were statistically significant (all P ＜ 0.05).Conclusions Antibiotic exposure leads to changes of enteric microbiota,which adversely affects local mucosal immunity and intestinal barrier function of colon in juvenile mice.