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Objective:To evaluate the development and application of gastrointestinal endoscopy technology in Beijing-Tianjin-Hebei (BTH) region from 2016 to 2020, and the impact of the corona virus disease 2019 (COVID-19) epidemic on gastrointestinal endoscopy screening and lesion detection rate of medical institutions.Methods:Data of gastroscopy and colonoscopy cases from 26 cooperative institutions in BTH Region Gastrointestinal Endoscopy Medical Association from January 2016 to December 2020 were collected by questionnaire. The number of gastrointestinal endoscopy, the detection of main lesions (including upper gastrointestinal malignant tumors, early gastric cancer and colon cancer), and the number of endoscopic treatment were retrospectively analyzed by year.Results:From 2016 to 2019, the number of gastroscopy and colonoscopy showed a yearly increasing trend with an annual growth rate of over 10%. Compared with 2019, the number of gastroscopy and colonoscopy decreased by 10.86% and 8.29%, respectively, in 2020 due to the impact of the epidemic. The annual detection rates of upper gastrointestinal malignant tumors, early gastric cancer and colon cancer were on a rise, from 7.22%, 1.49% and 8.98% in 2016 to 9.87%, 2.71% and 12.04% in 2020, respectively. The number of gastroscopic mucosal resection, submucosal dissection and colonoscopic endoscopic submucosal dissection increased yearly, from 2 132, 300 and 217 cases in 2016 to 5 466, 872 and 560 cases in 2020, respectively.Conclusion:The Medical Association has promoted the expansion of endoscopic screening and the application of endoscopic treatment techniques, resulting in a continuous increase in the endoscopy detection rate and early cancer diagnosis rate in the BTH region. The sharp decrease of gastrointestinal endoscopy procedures and the increase in the lesion detection rate in 2020 reflect the impact of epidemic COVID-19 on detection of gastrointestinal cancers.
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Objective To study the changes of plasma endotoxin and procalcitonin in patients with esophagogastric varices and provide a theoretical basis for prophylactic antibiotics after endoscopic treatment. Methods Fifty cases of patients with esophageal and gastric varices accepted the endoscopic treatment.The patients were divided into antibiotic group (32 cases)and non-antibiotic group (18 cases).The plasma endotoxin and procalcitonin were measured before and on the first day and 7th day after endoscopic treatment.Results The plasma levels of endotoxin and procalcitonin were not significantly different on the first and 7th day after endoscopic treatment compared with preoperative levels in antibiotic group.But in non-antibiotic group,the levels significantly increased on 7th day after endoscopic treatment compared with preoperative levels (P <0.05).And in patients of Child-Pugh A grade,the level of plasma procalcitonin significantly increased on 7th day after endoscopic treatment compared with preoperative levels (P <0.01), but the procalcitonin was not significantly different on the first and 7th day after operation.And in patients of Child-Pugh B and C grades,the levels of plasma endotoxin and procalcitonin significantly increased on the 7th day(P <0.01).Conclusion The levels of plasma endotoxin and procalcitonin in non-antibiotic group increase after endoscopic treatment,which suggests the risk of infection.Prophylactic antibiotics after endo-scopic treatment should be considered for the patients of Child-Pugh B and C grades.
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Objective To investigate the protective effects of α-lipoic acid in rats with acute panereatitis(AP)and its potential mechanism.Methods Wistar rats were randomly divided into four groups according to random number table:sham operation(SO)group,AP group,normal saline(NS)group and α- lipoic acid group with 30 rats in each group.AP model was induced by retrograde iniection of 3.5%sodium taurocholate into the pancreatobiliary duct.Rats in α-lipoic acid group immediately received α-lipoic acid intra- peritoneal injection at the dose of 1 mg/kg.Rats in NS group received sanle amount of normal saline.The rats were sacrificed at 1,3,6,9 and 12 h after AP induction.The serunl levels of amylase.TNF-α and ICAM-1 were measured.Pancreatic histological changes were observed.The activities of pancreatic SOD and MDA were measured. Results In rats of AP group,optical microscopy showed pancreatic edema,adhesion and necrosis. The semm amylase,TNF-α,ICAM-1 and MDA levels in pancreatic tissue 6h after operalion were(2211±547)U/L,(174.8±7.9)ng/ml,(49.3±8.0)ng/ml and(32.2±5.9)U/mg prot,respectively,in AP group;which were significantly increased when compared with those of SO group(P<0.05).Pancreatic SOD activity was(38.5±9.5)U/mg prot,which was signifieandy lower than(56.7±6.7)U/mg pint of SO group (p<0.05).The serum amylase,TNF-α,ICAM-1 and MDA levels in pancreatic tissue 6 h after operation in α-lipoic acid group were(1478±642)U/L,(164.8±6.2)ng/ml,(37.5±3.9)ng/ml and(20.2 ±8.4)U/mg prot,respectively;which were significantly decreased when compared with those of AP group(P<0.05).Pancreatic SOD activity was(66.0±8.6)U/mg prot,which were significantly hisher than(38.5±9.5)U/mg prot of AP group(P<0.05).Condusiors The pathogenesis of AP wag associated with oxiddative stress,and α-lipoic acid as an antioxidant played a role in the treatment of AP.the possiblemechanismsincludedinhibitedproduction of TNF-α and ICAM-1.