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Objective:To evaluate the effects of hemoclips on preventing delayed bleeding for early gastric cancer (EGC) after endoscopic submucosal dissection (ESD).Methods:Clinical data of 459 patients who underwent ESD for EGC in Beijing Friendship Hospital from June 2013 to August 2020 were collected retrospectively. Patients were divided into group A (hemoclip group, n=162) and group B (non-hemoclip group, n=297) according to whether preventive hemostatic clip treatment was performed after resection. Delayed bleeding within 2 weeks after ESD was observed. Univariate analysis and subgroup analysis were conducted for the delayed bleeding incidence and clinicopathological features. Results:Delayed bleeding incidences of group A and group B were 3.1% (5/162) and 8.1% (24/297) with significant difference between the two groups ( χ2=4.418, P=0.036). Subgroup analysis showed that there were significant differences in the delayed bleeding incidence between the two groups when the diameter of the tumor >20 mm [3.5% (2/57) VS 15.3% (13/85), χ2=5.016, P=0.025], the tumor located in the lower part of the stomach [1.0% (1/97) VS 10.4% (20/192), χ2=8.425, P=0.004], and the depth of tumor invasion was M/SM1 [3.2% (5/157) VS 8.1% (23/285), χ2=4.072, P=0.044]. There were no significant differences in the delayed bleeding incidence between group A and group B when the diameter of the tumor ≤20 mm, the tumor located in the upper/medial part of the stomach and the depth of tumor invasion was SM2 ( P>0.05). Conclusion:Hemoclips can prevent delayed bleeding after ESD for EGC, which is mainly observed in a tumor of diameter >20 mm, located in the lower part of the stomach and M/SM1 tumor invasion. It has little effect on the prevention when the tumor diameter ≤20 mm and located in the upper/medial part of the stomach.
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Objective:To evaluate the efficacy and safety of SPOT (GI Supply, USA), a new carbon-based permanent marker approved by the Food and Drug Administration (FDA), in the endoscopic marking for gastrointestinal lesions.Methods:A total of 115 patients with gastrointestinal lesions who underwent endoscopic treatment or surgery in Beijing Friendship Hospital or Beijing Chao-Yang Hospital from April 2019 to November 2019 were enrolled in the study. SPOT was used to mark the lesions, and marking points were found during endoscopic treatment or surgery to calculate the effective marking rate by single-group target value method. Adverse events after marking were recorded, and the changes of blood routine test, liver and kidney functions before and after marking were compared.Results:The effective rate of endoscopic marking with SPOT was 99.13% (114/115). The longest marking time was 57 days. There was no puncture of intestinal wall or injection into abdominal cavity during the marking process. One patient developed mild fever after marking. The incidence of adverse events was 23.48% (27/115), which were all unrelated to the test equipment. There was no significant difference in blood routine tests or liver and kidney functions before and after marking ( P>0.05). Conclusion:SPOT produced by GI Supply can effectively mark gastrointestinal lesions without serious adverse events, which meets the requirements of clinical use.
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Objective@#To define radiographic features that response to serial casting and bracing for progressive early-onset scoliosis (EOS).@*Methods@#A retrospective study of a total of 20 patients (10 females and 10 males) with complete radiographic data diagnosed as progressive early onset scoliosis treated with serial cast or brace for at least 12 months in the 306th Hospital of PLA from June 2011 to April 2018. Ages at initial diagnosis were all less than 5 years old. They were divided into two groups according to the main curve degree, those with cobbs angles more than 50 degree treated with serial cast, or else with brace. All the cases have radiographs of pretreatment, posttreatment, and last follow-up, and anteroposterior (lateral) film of the full length spine in standing position were taken to evaluate magnitudes and balance of coronal and sagittal malformations. We compared the general data of the two groups by independent sample t test and that of pretreatment, posttreatment and the last follow-up by paired-sample t test.@*Results@#According to the effective standard of not less than 10 degrees improvement, 9 of them were effective, 4 cast and 5 brace, the effective rates were 44.44% and 45.45%, 3 cases from brace group progressed. The magnitudes of the main curve improved significantly after the first treatment of cast and brace (55.4±24.36 vs 42.35±23.62) degree (t=5.850, P=0.000), and at the last follow up, the curve decreased slightly compared of that before interventions (55.4±24.36 vs 51.8±26.33). The compensatory curves, segmental kyphosis, thoracic kyphosis, lumbar lordosis, balance of both coronal and sagittal also had no significant differences between the primal and the latest follow up. The widths 159.63±19.27 mm, 160.81±14.54 mm, 176.08±28.10 mm (t=3.942, P=0.001; t=-3.096, P=0.006) and heights 153.78±29.24 mm, 161.14±29.53 mm, 175.01±36.91 mm of the thoracic were significantly different between pre-posttreatment and the last follow up (t=-5.950, P=0.000; t=-3.997, P=0.001). Serial cast and brace application can preserve the growth of the thorax.@*Conclusion@#Serial cast and brace are viable growth friendly methods to deal with progressed EOS, Although a cure improvement cannot be always expected, they can stabilize relatively large curves in young children and may help delay eventual surgical intervention.
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To define radiographic features that response to serial casting and bracing for progressive early-onset scoliosis (EOS). Methods A retrospective study of a total of 20 patients (10 females and 10 males) with complete radio?graphic data diagnosed as progressive early onset scoliosis treated with serial cast or brace for at least 12 months in the 306th Hos?pital of PLA from June 2011 to April 2018. Ages at initial diagnosis were all less than 5 years old. They were divided into two groups according to the main curve degree, those with cobbs angles more than 50 degree treated with serial cast, or else with brace. All the cases have radiographs of pretreatment, posttreatment, and last follow?up, and anteroposterior (lateral) film of the full length spine in standing position were taken to evaluate magnitudes and balance of coronal and sagittal malformations. We com?pared the general data of the two groups by independent sample t test and that of pretreatment, posttreatment and the last follow?up by paired?sample t test. Results According to the effective standard of not less than 10 degrees improvement, 9 of them were ef?fective, 4 cast and 5 brace, the effective rates were 44.44% and 45.45%, 3 cases from brace group progressed. The magnitudes of the main curve improved significantly after the first treatment of cast and brace (55.4±24.36 vs 42.35±23.62) degree (t=5.850, P=0.000), and at the last follow up, the curve decreased slightly compared of that before interventions (55.4±24.36 vs 51.8±26.33). The compensatory curves, segmental kyphosis, thoracic kyphosis, lumbar lordosis, balance of both coronal and sagittal also had no significant differences between the primal and the latest follow up. The widths 159.63±19.27 mm, 160.81±14.54 mm, 176.08± 28.10 mm (t=3.942, P=0.001; t=-3.096, P=0.006) and heights 153.78±29.24 mm, 161.14±29.53 mm, 175.01±36.91 mm of the thoracic were significantly different between pre-posttreatment and the last follow up (t=-5.950, P=0.000; t=-3.997, P=0.001). Se? rial cast and brace application can preserve the growth of the thorax. Conclusion Serial cast and brace are viable growth friendly methods to deal with progressed EOS, Although a cure improvement cannot be always expected, they can stabilize relatively large curves in young children and may help delay eventual surgical intervention.
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Objective To investigate the effect of modified suture on the maternal skin healing, scar healing and satisfaction to cesarean section. Methods A total of 244 cases of cesarean section in our hospital from January 2015 to January 2016 were randomly collected and divided into observation group (n=143) and control group (n=101). Patients in the observation group were treated with the modified suture method, and the control group was given the conventional method to suture the skin. The VAS score, suture time and complication rate were observed in the 2 groups. Results The VAS scores were significantly lower at one week and one month after operation (1.15±0.43 and 0.07±0.01, respectively) than those of the control group (1.40±0.51 and 0.13±0.03, respectively, P<0.05). The suture time were significantly shorter in the observation group (5.12±0.95) than those of control group (7.28±0.83, P<0.05). Postoperative complication rate was significantly lower in observation group (2.80%) than that of control group (9.90%, P<0.05). The comfort level to incision and satisfaction rate to scar were significantly higher (94.41% and 95.10%, respectively) than those of control group (83.17% and 87.13%, respectively). The average thickness of scars at day 90 and day 180 after operation were significantly less in the observation group [(2.14±0.32) mm and (3.08±1.02) mm, respectively] than those of the control group [(3.10±0.48) mm and (5.22±1.10) mm, respectively, P<0.05)]. Conclusion The improved suture method after cesarean section has the advantages of shorter suture time, less poor wound healing, higher maternal satisfaction rate.
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Objective To investigate the safety and efficacy of three column osteotomy (3-CO) procedures through previous spinal fusion site for the revision surgical treatment in severe spinal deformity patients.Methods From Oct.2010 to May 2014 in our hospital,a total of 12 severe spinal deformity patients underwent 3-CO for the revision surgical treatment.There were 7 males and 5 females with the average age of (21.8±3.8) years,ranging from 18 to 30 years.The mean time from the initial operation to the revision surgery was (10.2±4.8) years (ranging from 3 to 17 years).The reasons for revision were:curve progression in 7 patients,neurologic deficit in 2 cases,implant failure in 1 patient and pseudarthrosis in 2 patients.The coronal parameters including major Cobb angle and distance between C7 plumb line and center sacral vertical line (C7PL-CSVL),and the sagittal parameters including global kyphosis curve and sagittal vertical axis (SVA) were measured pre-operatively,post-operatively and at last followup,respectively.The operation time,intraoperative blood loss and complications were recorded.The paired t test was used to evaluate the difference among pre-revision,post-revision and last follow-up.Results The average operation time was (451.7±83.1) min (range,320-600 min) and the average blood loss was (4 016.7± 1 080.0) ml (range,2 700-6 000 ml).The average follow-up time after revision operation was (35.4±9.8) months (range,24-49 months).The coronal Cobb angles of pre-revision and post-revision were 83.8°±23.3°and 34.6°± 13.7°.The average correction rate was 60.1％ ±8.8％.At last follow-up,the average coronal Cobb angle was 34.9°±13.8°,there was no significant loss of correction.The pre-revision and post-revision values of global kyphosis were 99.1°±13.3°and 38.7°±7.8° with a mean correction rate of 60.8％ ±6.7％.At the last follow-up,the average global kyphosis was 39.3°±7.5°and no loss of correction was found.For the C7PL-CSVL and SVA,pre-revision (30.3± 17.1) mm and (40.1±31.1) mm were corrected to (14.3 ±7.6) mm and (19.1± 12.3) mm immediately after revision operation,respectively.At final follow-up,the average C7PL-CSVL and SVA were(14.1 ± 7.6) mm and (19.6± 12.1) mm,the correction was well maintained.Obviously,two patient's neurological status improved from Frankel C before revision surgery to Frankel E.Complications were encountered in five patients (41.7％),including SEP signal changed in 1 patient (8.3％),transient neurologic deficit after revision surgery in 1 patient (8.3％),cerebrospinal fluid leak in 1 patient (8.3％),and pleural effusion in 2 patients (16.7％).During the follow-up time,there was no patient experienced pseudarthrosis,implant failure,infection or significant loss of correction.Conclusion Based on results of this study,it was concluded that 3-CO procedures through previous spinal fusion sites could obtain satisfactory and safety results in severe spinal deformity revision surgery.However,it is a technique-demanding procedure with more blood loss,longer operative time and higher risk of perioperative complications.
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Objective To study the healing response of a tissue engineered bone of bMSCs combined rFN/CDH-BCP in a rabbit model. Methods The biomimetic surface was achieved by immobilizing rFN/CDH onto biphasic calcium phosphate ceramic ( BCP) covalently. The effect of rFN/CDH-BCP on adhesion,proliferation and differentiation were evaluated comprehensively by using cell centrifugal adhesive as-say,MTT method,SEM,Alkaline phosphatase ( ALP) activity and alizarin red staining respectively. A rabbit lumbar fusion model was estab-lished by implanting bMSCs combined rFN/CDH-BCP into intertransverse process space of L4 ~L5 ,the fusion site bone formation was ob-served by imaging means,histological techniques was used to observe the new bone formation and distribution of seed cells. Results Cell centrifugal adhesive assay indicated the adherent bMSCs on rFN/CDH-BCP associated with the ligand density,the biomimetic surface posses-ses excellent biocompatibility. The ALP activity on rFN/CDH-BCP surface was the highest among all samples on the 10th day after induction (P<0. 05). On the 21st day,alizarin red staining showed that the oval-shaped and orange-red nodules,either the number or the area,distrib-uted wider on rFN/CDH-BCP surface. The results from X plain after 3 months revealed a fuzzy gap between material and bone bed,and higher cover rate of intertransverse process space with new bone deposition on rFN/CDH-BCP surface. Conclusion Histologically,rFN/CDH-BCP exhibited as interlacing bone trabecula bridging biomaterial suface and cortical bone of transverse process continously. The bone mass was much more than the ture BCP class. The comprehensive data reveals that when loaded with MSCs,rFN/CDH-BCP demonstrates superior char-acteristics of osteoconduction and osteoinduction,and substantially enhances healing capacity in vivo.
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Objective: To develop a quantitative PCR method for detecting hookworm infection and quantification. Methods:A real-time PCR method was designed based on the intergenic region II of ribosomal DNA of the hookworm Necator americanus. The detection limit of this method was compared with the microscopy-based Kato-Katz method. The real-time PCR method was used to conduct an epidemiological survey of hookworm infection in southern Fujian Province of China. Results:The real-time PCR method was specific for detecting Necator americanus infection, and was more sensitive than conventional PCR or microscopy-based method. A preliminary survey for hookworm infection in villages of Fujian Province confirmed the high prevalence of hookworm infections in the resident populations. In addition, the infection rate in women was significantly higher than that of in men. Conclusions: A real-time PCR method is designed, which has increased detection sensitivity for more accurate epidemiological studies of hookworm infections, especially when intensity of the infection needs to be considered.
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The main aim of this study was to transform the enhanced green fluorescent protein gene (egfp) into biocontrol fungus Paecilomyces lilacinus strain 9410. We constructed the expression vector pUPNGT of the fusion gene nptII-egfp using pcDNA3.1(-) as a helper plasmid. The egfp gene was then transformed into P. lilacinus strain 9410 via Agrobacterium tumefaciens-mediated transformation. PCR and Southern blotting analysis showed that the egfp gene was integrated into the genomes of the tested transformants and the integration manner was single-copy. The transformants could generate green fluorescence when they were excited by 488 nm blue laser. These results indicated that the egfp gene had been successfully transformed into P. lilacinus 9410 and expressed in the tested transformants. Our work may provide a new approach to assess environmental safety and practical biocontrol efficacy ofP. lilacinus under different conditions.