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China is a country with high incidence of gastrointestinal (GI) cancer. Gastric cancer, esophageal cancer and colon cancer seriously threaten the health of people, and leads to heavy medical burdens. This review discusses the current screening protocol of GI cancer and pancreatic cancer. It also interprets the relevant policies issued by the state in recent years, and evaluates the effects of new technologies such as serum pepsinogen combined with gastrin in detecting gastric cancer, fecal and blood gene detection for colon cancer, and "serum liquid biopsy" of pancreatic cancer for early cancer screening. We also point out the difficulties and challenges in cancer screening at early stage, and the significance of promoting early cancer screening to reduce the mortality of GI cancer in China.
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Acute pancreatitis (AP) is the most common severe disease of digestive system, with high morbidity and mortality. In 2019, the latest version of guidelines for the management of acute pancreatitis (Shenyang, 2019) was launched. Starting from the etiology and classification of AP, the guidelines proposed 30 statements on the diagnosis and treatment of AP. The guideline fully reflected the level of evidence and consensus level of experts and provided suggestions for the clinical management of AP in the future. This review summarizes the key points of updating the guidelines, focusing on the classification principle of AP, the change of etiology, the unification of diagnostic name, the strategy of fluid resuscitation and antibiotic use to strenthen the understanding of the guidelines for better clinical practice.
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Small bowel endoscopy (enteroscopy) is an important technique for diagnosis and treatment of small intestinal diseases. This review summarizes the updated points of the 2018 edition of the Chinese Guideline for Clinical Application of Enteroscopy. It expounds the contents of the guideline from four aspects: indications and contraindications of enteroscopy, the role of enteroscopy in the diagnosis process of small intestinal diseases, the operation skills of enteroscopy, and the expansion of the therapy field of enteroscopy. The current guideline also included many native clinical evidences, which is of great significance in guiding the clinical practice of enteroscopy in China.
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Gastric cancer is the one of human tumor disease that is directly related to bacterial infection disease. Helicobacter pylori(Hp)is a cancer-causing pathogen, whose prevalence rate in the population is as high as 50%. The indications for Hp eradication have been developong; however, for infected people, especially for the asymptomatic infection group, it remains controversial whether to perform the eradication therapy. This review describes the cost-effectiveness of eradicating Hp and the prevention and treatment of gastric cancer,based on the current situation of health care in China and from the perspective of health economics, so as to provide some ideas for the prevention and treatment of gastric cancer with domestic Hp infected people.
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Helicobacter pylori(Hp)is a persistent infection that affects more than 60% of the global population.It is associated with many gastrointestinal diseases and even can lead to cancer.H. pylori-infected individuals should be offered eradication therapy, which can also prevent the morbidity of gastrointestinal diseases effectively. Due to the extensive use of antibiotics and the increase of adverse reactions,the eradication rate shows a downward tendency. In recent years, researches have been done focusing on the treatments which can reduce the antibiotic resistance of Helicobacter pylori. This article aims to elaborate the current situation of antibiotic resistance and the eradication of Helicobacter pylori, and discuss the relationship between them.
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Since the National Institute of the United States proposed the first Helicobacter pylori(Hp)eradication indication, peptic ulcer,in 1994, the indications of Hp eradication has been modified and expanded continuously.In 2015, Kyoto global consensus report on Helicobacter pylori gastritis proposed that “H. pylori-infected individuals should be offered eradication therapy, unless there are competing considerations”, which means that Hp eradication indications are no longer needed. This article aims to elaborate the evolution process of Hp eradication indications in China based on the five Chinese consensus reports of Hp infection treatment, and provide an outlook of the indications in the future.
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Gastric cancer is a serious threat to human health. A large number of studies have found that Helicobacter pylori(Hp)infection is closely related to gastric cancer. Japan has reduced the incidence of gastric cancer by eradicating Hp, which is worth learning.This review shows the evidence that Hp infection increases the risk of gastric cancer, and draws on Japan's strategy of radically treating Hp to prevent gastric cancer. Based on China's national conditions, this review proposes the method to eradicate Hp and prevent gastric cancer in China.
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Gastric cancer has become the world's fourth most common malignant tumor, and the second leading cause of cancer death worldwide. Helicobacter pylori(H.pylori) infection is a major risk factor of occurrence and development of gastric cancer. In the multistage pathogenesis of gastric cancer, H.pylori infection induces chronic active gastritis slowly, which develops into gastric cancer in the end through precancerous stage of atrophic gastritis, intestinal metaplasia and hyperplasia. Related researches prove that eradication of H.pylori, particularly in the early stage, can effectively prevent the occurrence of gastric cancer. In some cases, the eradication of H.pylori can prevent the development of gastric precancerous lesions and reverse them. This paper will elaborate on the role of H.pylori eradication in the prevention of gastric cancer.
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Severe acute pancreatitis is a common critical emergency in the digestive system. It is difficult to treat in clinic and has high mortality. According to the new Atlanta classification standard proposed in 2012, the treatment of acute pancreatitis mainly focused on early indentification, maintenance of organ function, anti-inflammatory response, intestinal function maintenance and other measures, so as to improve the success rate of the treatment. As more patients with severe acute pancreatitis have successfully crossed the acute phase, the prevention and treatment of subsequent complications of acute pancreatitis have been increasingly valued. To focus on the “secondary attack” of acute pancreatitis, it is necessary to carry out clinical research on the subsequent complications such as the accumulation of peripancreatic fluid, infectious necrosis, and vascular complications, and to reduce the mortality. This is a change in the focus of acute pancreatitis treatment and a further extension of the concept of multidisciplinary collaboration in acute pancreatitis.
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Objective To compare the image quality of sinus coronal CT scan before and after the involvement of quality control circle (QCC) to explore QCC's effect.Methods A QCC team was founded in April 2014,in which 10 key steps of QCC activities were executed,and the related data from April to November 2014 were analyzed to determine the effect of QCC on coronary sinus CT examination.Results The rate of excellent film was increased from 69.5％ to 96.3％ after the involvement of QCC,and the desired requirement was met.Conclusion QCC contributes to improving coronary sinus CT examination and enhancing the ability of the members,and thus is worthy promoting clinically.
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Objective To compare the image quality of sinus coronal CT scan before and after the involvement of quality control circle (QCC) to explore QCC's effect.Methods A QCC team was founded in April 2014,in which 10 key steps of QCC activities were executed,and the related data from April to November 2014 were analyzed to determine the effect of QCC on coronary sinus CT examination.Results The rate of excellent film was increased from 69.5％ to 96.3％ after the involvement of QCC,and the desired requirement was met.Conclusion QCC contributes to improving coronary sinus CT examination and enhancing the ability of the members,and thus is worthy promoting clinically.
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Objective To explore coronary CT three-dimensional post-processing standardized display and the construction of digital teaching platform. Methods The conventional display positions of 3D post-processing image were summarized during daily coronary CTA examination, the common place was refined. The construction mode was explored for CTA digital teaching demonstration platform. Results Coronary CTA 3D post-processing standardized display with common and individual property contributed to enhancing the display of coronary images. The CTA digital teaching demonstration platform met the teaching requirements. Conclusion The coronary CT 3D post-processing standardized display and digital teaching platform facilitate the student to master related knowledge.
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Objective To investigate influencing factors of disability after craniocerbral injury caused by road traffic accident.Methods We collected 486 cases with craniocerebral injury caused by traffic accident,and conducted analysis.Factors related to disability were found by univariate analysis,and multivariate logistic regression analysis was conducted to filter the most important factors.Results Degrees of brain injury,drunk driving,age and types of accident were the major influencing factors.Drunk driving and age were positively related with disability grade while the degree of brain injury and type of accident were negatively related.Concuusiorn It is helpful to reduce disability and the burden on society by taking intervening measures on the related factors of disability after brain injury in road traffic accident.
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Objective To observe the effects of repetitive transcranial magnetic stimulation (rTMS) combined with abdominal muscle electrical stimulation on the pulmonary ventilation of patients with cervical spinal cord injury.Methods Twenty-five patients with cervical spinal cord injury were randomized into an experimental group (n =13) and a control group (n =12).The control group was given comprehensive rehabilitation treatment,including upper limb movements,standing training and training of respiratory function,while the experimental group was given repetitive transcranial magnetic stimulation and abdominal muscle electrical stimulation in addition to the comprehensive rehabilitation treatment.The patients' maximum lung capacity (VC),forced expiratory volume for 1 second (FEV1),peak expiratory flow rate (PEF) and tidal volume (VT) were measured at the outset and after 3 months of treatment.Results The lung function indexes increased in both groups after treatment,but each index improved significantly more in the experimental group,on average,than in the control group.Conclusion As a supplement to routine respiratory function training,repetitive transcranial magnetic stimulation combined with abdominal intermediate frequency electrical stimulation can improve the pulmonary ventilation function of patients with middle and lower cervical spinal cord injury.
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<p><b>OBJECTIVE</b>To study the expressions of differential proteins in the expressed prostatic secretion (EPS) of patients with III A chronic prostatitis and healthy men.</p><p><b>METHODS</b>We collected EPS samples from 35 patients with III A chronic prostatitis and 18 age-matched healthy men, and detected the differentially expressed proteins in EPS by MALDI-TOF/MS. Based on the data obtained, we conducted a statistical analysis on the mass-to-charge (m/z) ratios of different proteins and a retrieval analysis on the relevant proteins using the protein database.</p><p><b>RESULTS</b>In the comparative studies of the III A chronic prostatitis patients and healthy men, 5 proteins were detected as at least 2-fold differentially expressed, which were probably brevinin-2Eg, big endothelin-1, alpha-defensin 15, beta-defensin 134 and prostatic steroid-binding protein C2. The m/z ratios were significantly up-regulated in 3 372, 3 487, 425 and 5 325 Da proteins (P < 0.01) and down-regulated in 10631Da (P < 0.01).</p><p><b>CONCLUSION</b>Proteins are differentially expressed in the EPS of III A chronic prostatitis patients and healthy men, and these proteins may be significantly correlated with the development and progression of III A chronic prostatitis.</p>
Subject(s)
Adult , Humans , Male , Young Adult , Body Fluids , Metabolism , Case-Control Studies , Chronic Disease , Defensins , Metabolism , Endothelin-1 , Metabolism , Prostate , Bodily Secretions , Prostatitis , Classification , MetabolismABSTRACT
<p><b>BACKGROUND</b>The role of gastro-protecting agents on symptomatic chronic gastritis is unclear. This multicenter, open, randomized trial was designed to compare the comprehensive effects of gefarnate with sucralfate on erosive gastritis with dyspeptic symptoms.</p><p><b>METHODS</b>Totally 253 dyspepsia patients confirmed with erosive gastritis were enrolled from six centers in China. They randomly received either daily 300 mg gefarnate or 3 g sucralfate for six weeks. The primary endpoint was the effective rate of both treatments on endoscopic erosion at week six.</p><p><b>RESULTS</b>Gefarnate showed an effective rate of 72% and 67% on endoscopic score and dyspeptic symptom release, which is statistically higher than sucralfate (40.1% and 39.3%, P < 0.001, intension-to-treat). For histological improvement, gefarnate showed both effective in decreasing mucosal chronic inflammation (57.7% vs. 24.8%, P < 0.001, intension-to-treat) and active inflammation (36.4% vs. 23.1%, P < 0.05, intension-to-treat) than the control. A significant increase of prostaglandins and decrease of myeloperoxidase in mucosa were observed in gefarnate group. Severity of erosion is non-relevant to symptoms but Helicobacter pylori (H. pylori) status does affect the outcome of therapy.</p><p><b>CONCLUSIONS</b>Gefarnate demonstrates an effective outcome on the mucosal inflammation in patients with chronic erosive gastritis. Endoscopic and inflammation score should be the major indexes used in gastritis-related trials.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Anti-Ulcer Agents , Therapeutic Uses , Dyspepsia , Drug Therapy , Gastritis , Drug Therapy , Gefarnate , Therapeutic Uses , Sucralfate , Therapeutic Uses , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To explore the clinical features and treatment of spermatic cord liposarcoma (SCL).</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of a case of SCL, reviewed the related literature and investigated the diagnosis and treatment of the disease.</p><p><b>RESULTS</b>The patient underwent tumor resection and left inguinal orchidectomy. Postoperative pathology confirmed the case to be s SCL. Neither recurrence nor metastasis was found during the five-month follow-up.</p><p><b>CONCLUSION</b>SCL is a rare medical condition with no specific imaging and laboratory features. Radical orchidectomy with wide local excision of the mass is recommended for its treatment, and adjuvant radiotherapy can be considered in intermediately or highly differentiated tumors and recurrent liposarcomas, while the role of chemotherapy is not well-defined.</p>
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Humans , Male , Middle Aged , Genital Neoplasms, Male , Diagnosis , Therapeutics , Liposarcoma , Diagnosis , Therapeutics , Spermatic Cord , PathologyABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical manifestation, biological behavior, diagnosis and treatment of the urothelial inverted papilloma.</p><p><b>METHODS</b>Sixty-two cases of urothelial inverted papilloma were analyzed retrospectively from January 1990 to August 2008. Of the 62 patients, 51 were men and 11 were women. The average age at presentation was 56.4 years old. Fifty-six cases were solitary tumors and 6 were multiple. The most common compliant was macroscopic hematuria. The tumor located at the ureter in 5 cases. Of these cases, 4 were treated by local excision, 1 by nephroureterectomy. One case of multiple ureteral inverted papilloma with coexistent bladder inverted papilloma was treated by total cystectomy. The tumor located at the bladder in 52 cases, with 44 treated by transurethral resection of bladder tumor, 6 by partial cystectomy, 2 by total cystectomy. Four cases had the tumor located at the urethra, with 1 treated by transurethral resection of tumor, 3 by tumorectomy.</p><p><b>RESULTS</b>The postoperative pathological diagnosis of all the 62 cases was inverted papilloma, synchronous urothelial carcinoma in 7. Follow-up data were available in 49 cases. Two cases had a recurrence at 7 months and 79 months, respectively. Three case of subsequent transitional cell carcinoma developed 18 months, 2 years and 6 years later, respectively.</p><p><b>CONCLUSIONS</b>Inverted urothelial papilloma is a kind of benign tumor. It should be differentiated from malignant urothelial tumors. Surgical operation is the main treatment choice. Cystoscopic surveillance and followup are necessary after the operation regularly.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Follow-Up Studies , Papilloma, Inverted , Diagnosis , General Surgery , Retrospective Studies , Urologic Neoplasms , Diagnosis , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To evaluate the molluscicidal activities of methanol extract of Jatropha curcas leaves against Ampullaria gigas.</p><p><b>METHODS</b>Young snails, adult snails and eggs of Ampullaria gigas were treated with the methanol extract of J. curcas leaves at different doses for different time lengths and the molluscicidal effects of the extract were evaluated.</p><p><b>RESULTS</b>The methanol extract showed a significant molluscicidal effect on the young snails at a low concentration, and treatment with 75 mg/L extract for more than 3 days resulted in a 100% mortality rate of the young snails. The Jatropha leaf methanol extract also showed toxicity to adult snails and eggs.</p><p><b>CONCLUSION</b>Jatropha leaves have a great potential for developing green pesticides to control Ampullaria gigas, but its biochemical mechanism needs further research.</p>
Subject(s)
Animals , Jatropha , Chemistry , Methanol , Chemistry , Molluscacides , Pharmacology , Plant Extracts , Pharmacology , Plant Leaves , Chemistry , Snails , ClassificationABSTRACT
Objective To construct a nucleic acid vaccine expressing H.pylori HpaA and inter- leukin-2 gene and to identify the immunogenicity of the vaccine proteins in vitro and protection in vivo. Methods The H paA gene fragment was amplified by polymerase chain reaction(PCR) from the genomic DNA of the standard H.pylori strain 17874.Mouse interlukin(IL)-2 gene was amplified from pClneo- IL-2.The HpaA and IL-2 were cloned into pUCmT vector.After DNA sequences of the amplified HpaA gene and IL-2 were confirmed,both were cloned into the eukaryotic expression vector pIRES through a serial of enzyme digestion and ligation reactions.The recombinant plasmids were screened by PCR and restriction enzyme digestion.Then,recombinant pIRES-HpsA-IL-2 was transfected to COS-7 cells using Lipofectamine~(TM)2000.The immunogenicity of HpaA and IL-2 protein was detected by SDS- PAGE and Western blot.The recombinant plasmids were transformed to LB5000 and then to final host SL7207.The recombinant strains were passaged repeatedly.The mice were challenged with H.pylori after 4 weeks of inoculation of nucleic acid vaccine.H.pylori infection was detected by rapid urease test.Results The amplified HpaA gene fragment and IL-2 were confirmed by sequence analysis.The eukaryotic expression vector plRES and the pIRES-HpaA-IL-2 construction were confirmed by PCR and restriction digestion.The expressions of HpaA(30 000) and IL-2(14 000)protein by pIRES-HpaA-IL- 2 were detected by Western blot.The in vivo study showed that 75.0% and 58.4% of mice vaccinated by HpaA-IL-2 and HpaA,respectively,were protected anaigst H.pylory infection,which was signifi- cant different in comparison with PBS control (P