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ObjectiveTo analyze the articles on endoscopic retrograde cholangiopancreatography (ERCP), an important method for minimally invasive treatment of biliary and pancreatic diseases, published worldwide, and to investigate the status, hotspots, and development trends in this field. MethodsThe web of science core collection database in Web of Science platform was selected to search by the subject words “TS = (Cholangiopancreatography, Endoscopic Retrograde)”, for the articles published from January 1, 2015 to December 31, 2019, and the literature type was selected as “article”. CiteSpace 5.6.R2 (64-bit) was used to analyze the authors, key words, institutions, countries (regions), and references and plot visualized maps. ResultsA total of 1535 articles on ERCP were included. The analysis showed that Hiroyuki Isayama had the highest number of published articles, followed by Yousuke Nakai and Takeshi Ogura, and University of Tokyo had the highest number of published articles, followed by Shanghai Jiao Tong University and University of Ulsan College of Medicine. Moreover, the US, Japan, and China were the top three countries from the aspect of the number of published articles in the recent 5 years, and ERCP, complication, and risk factor were the key words with the highest frequency in the recent 5 years. The most frequently cited articles mainly focused on the complications of ERCP and related consensus or guidelines. ConclusionThe main research hotspots and trends in the field of ERCP are related factors and clinical prevention of ERCP-related complications.
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Objective@#To investigate hand hygiene of children in kindergartens in Huzhou City, so as to provide basis for improving hand hygiene and conduct health education on hand hygiene related diseases.@*Methods@#A total of 343 children in 6 kindergartens in two districts of Huzhou City were observed by stratified cluster random sampling and observation.@*Results@#A total of 1 042 hand hygiene indications and 886 hand washing (85.03%). The overall hand-washing qualification rate was 53.35%. Within different kindergartens, children in the lowest level kindergartens had poor hand washing habits. There was a positive correlation between levels of kindergarten and children’s hand washing habits. Boys’ hand washing habits were relatively poor, 45.35 percent of boys’ had substandard hand washing habits, which was only 19.88 percent of girl. The hand hygiene behavior of children in primary class was better than that of middle class. The proportion of substandard hand washing of children in primary class and middle class was 23.13% and 39.80% respectively.@*Conclusion@#There is a big promotion space of hand hygiene habits of children in kindergartens, so it is necessary to strengthen compliance with hand hygiene and cultivate correct hand hygiene habits.
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Objective@#To understand knowledge and awareness of hand-foot-mouth disease (HFMD) and associated factors among parents of kindergarten children in urban district of Huzhou City and to provide a veference for making effective measure of health education of HFMD.@*Methods@#Self-designed questionnaire was used to investigate 851 parents from 6 kindergartens by stratified cluster random sampling.@*Results@#The overall recognition of HFMD was 8.15±3.43, and the qualified rate was 5.17%. Awareness rates of sources, transmission routes, symptoms and signs, as well as preventive measures were 34.08%, 20.80%, 3.41% and 30.32%, respectively. Multiple linear regression analysis showed that kindergarten type(B=-1.07), gender(B=0.70), age(B=-0.41), education level(B=1.60), occupation (B=-1.37) associated with awareness of HFMD (P<0.05).The top three sources of HFMD prevention and treatment were mobile messages(45.24%), kindergarten lectures (43.24%) and brochure/propaganda column(40.19%) .@*Conclusion@#The general knowledge and awareness of HFMD among parents of kindergartens children’s parents is low in urban district of Huzhou city. In order to improve the awareness and health-related behaviors among parents of kindergarten children to prevent HFMD, child care institutions and basic public health service health education programs should be relied on, to carry out appropriate health communication and intervention.
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Objective To analyze the causes of delayed hemorrhage after colonoscopic treatment in colorectal diseases and the value of second colonoscopic treatment.Methods A retrospective study was conducted on 45 patients with colorectal protrusion lesions (polyps,adenoma,early carcinoma and lipoma) in the Daping hospital of the Third Military medical University from January 2010 to December 2016.The patients suffered from delayed hemorrhage after argon knife coagulation,submucosal resection,submucosal dissection or nylon snares colonoscopic treatment.The mode and clinical outcome of second colonoscopic treatment were summarized by aiming at the reasonsof delayed hemorrhage.Results The predilection sites of delayed hemorrhage were in turn rectum (28.89 ％),sigmoid colon (24.44 ％) and ascending colon (22.22 ％).Adenoma and intraepithelial neoplasia lesions were easier to occurr (88.89 ％).The types of delayed hemorrhage were mainly blood oozing at the lesion resection wound surface as well as blood gushing or ejection.The second colonoscopic treatment modes in these cases were mainly titanium clipping and ring clipping and suturing.Five cases were treated by submucosal injection of adrenaline (1 ∶ 10 000) combined with argon knife coagulation.Thirtyfive cases conducted argon knife coagulationcombined with titanium clipping,3 cases conducted titanium clipping and 2 cases adopted ring clipping hemostasis.Forty-two cases stopped bleeding by once colonoscopic treatment,while 3 cases suffered from re-bleeding,the colonoscopic treatment was performed again,1 case stopped bleeding after using titanium clipping and ring clipping hemostasis again,while other 2 cases were transfered to the surgery department for conducting colectomy.All 43 cases of delayed hemorrhage in this group were cured and discharged after successful hemostasis by colonoscopy.The firm wound treatment after colonoscopic treatment was very important for preventing delayed hemorrhage,and the underlying diseases and postoperative diet management were also the important factors of delayed hemorrhage.Conclusion Timely second colonoscopic examination and treatment can obtain satisfactory clinical effects in the patients sufferring from delayed hemorrhage after colonoscopic treatment.
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Objective To explore the clinical characters,treatment and prognosis of gastrointestinal Dieulafoy lesion in China.Methods Dieulafoy was used as search term,the literatures about Chinese patients with Dieulafoy lesions from January 1998 to October 2016 were retrieved in the Chinese literature library including China National Knowledge Infrastructure,VIP network,Wanfang database and China Biology Medicine disc,and a total of 515 literatures,5 145 patients were enrolled and analyzed.The gender,age,geographical distribution,location of the lesion,treatment and prognosis of the disease were summarized.Results Among the 5 145 patients (male 3 959,female 1 186) with Dieulafoy disease,the ratio of male to female was 3.34∶1.00.The age was from 3 to 95 years,and mean age was 51 years.The lesion location was mainly in stomach (88.82％,4 570/5 145) and second was small intestine (8.28％,426/5 145).In stomach,the lesions were mainly located in gastric corpus,fundus and cardia.The small intestinal Dieulafoy lesions were mainly located in duodenum.The main manifests were sudden hematemesis,melena,and hematochezia.The treatments mainly was endoscopic treatment (72.56％,3 733/5 145),and second was surgery (25.27％,1 300/5 145).Among the5 145 patients withDieulafoy disease,5 099 patients (99.11％) were cured and 46 patients (0.89％) died.The proportions of endoscopic treatment,interventional therapy and first endoscopic treatment within 24 hours in tertiary hospitals were all higher than those of nontertiary (all P＜0.01).The cure rate of tertiary hospitals (99.22％,3 674/3 793) was significantly higher than that of nontertiary hosptials (98.54％,1 421/1 442) (x2 =0.89,P＜0.05) and the mortality was significantly lower than that of nontertiary hospitals (P＜ 0.05).Conclusions The male is more susceptible to Dieulafoy lesion which occurred at any age than the female in China.The predilection sites of Dieulafoy lesion were stomach and duodenum.The primary treatments were endoscopic treatment and surgery,and the disease usually had a good prognosis.
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Background:Non-variceal vascular originated gastrointestinal bleeding has been attracted more and more attention in clinical practice. Because of the poor efficacy of conventional drug therapy and the high rebleeding rate,endoscopic therapy or interventional therapy have become the first choice. Aims:To investigate the therapeutic value of endoscopic therapy and interventional therapy in non-variceal vascular originated gastrointestinal bleeding. Methods:Retrospective analysis was performed in 77 patients with non-variceal vascular originated gastrointestinal bleeding who underwent endoscopic therapy or interventional therapy from January 2010 to May 2016 at Daping Hospital of the Third Military Medical University. The therapeutic efficacy of the two therapies was compared. Results:In 77 patients,48 patients received endoscopic therapy and 29 patients received interventional therapy. Compared with interventional therapy group, hemoglobin was significantly higher (P = 0. 007)and Blatchford score was significantly lower in endoscopic therapy group (P = 0. 021). Stomach lesion was found in 22 patients,25 in duodenum,18 in small intestine,9 in colon and 3 in rectum. Angiodysplasia lesion was found in 35 patients,ulcer combined with angiodysplasia in 26 patients,arterial rupture in 13 patients,and angiotelectasis in 3 patients. Rebleeding occurred in 7 patients underwent endoscopic therapy within 72 hours. No rebleeding was found in patients underwent interventional therapy,however,1 patients died from pulmonary embolism. Conclusions:Most patients with upper gastrointestinal angiodysplasia can benefit from endoscopic therapy. Surgery may be a better choice for those with more severe mucosal damage and rebleeding within 72 hours after treatment. Interventional treatment may be a first choice for those who have bleeding from small intestinal angiodysplasia,lower hemoglobin and a higher Blatchford score.
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Background:Esophageal non-variceal hemorrhage is relatively uncommon in clinical,however,it can be life-threatening in severe cases. Thus,retrospective analysis of esophageal non-variceal hemorrhage could provide important evidence for its diagnosis and treatment. Aims:To analyze the clinical characteristics of esophageal non-variceal hemorrhage. Methods:A total of 175 cases of esophageal non-variceal hemorrhage from January 2006 to December 2016 at Daping Hospital were enrolled. Gender,age,cause of bleeding,location of bleeding,season of onset,treatment and prognosis were retrospectively analyzed. Results:The ratio of male to female was 3. 5: 1 in 175 patients with esophageal non-variceal hemorrhage,73. 1％ of patients were middle-aged and elderly. The main cause of bleeding of esophageal non-variceal hemorrhage were cardiac mucosal laceration syndrome (46. 9％),esophageal cancer (23. 4％),esophageal ulcer (12. 6％)and esophageal foreign body (12. 0％). The most common site of bleeding was lower esophagus (70. 9％). Fifty-one patients accepted endoscopic treatment or surgery. After treatment,142 patients (81. 1％)were cured or improved,and death was occurred in 27 patients (15. 4％). Conclusions:The incidence of esophageal non-variceal hemorrhage is higher in male than in female,and is commonly seen in middle-aged and elderly patients. The most common cause of bleeding of esophageal non-variceal hemorrhage is cardiac mucosal laceration syndrome,and the most common site of bleeding is lower esophagus. Medicine combined with endoscopic treatment is effective for most of the patients.
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Objective Retrospectively analyzed the data of patients with delayed bleeding after colorectal polypectomy,summarized the risk factors and treatment methods of bleeding patients,and provided the basis for further prevention and treatment of postoperative delayed bleeding.Methods Collected the clinical data of 1 243 patients who were admitted into the department of gastroenterology of third affiliated hospital of the third military medical university and accepted polypectomy with colonoscopy from January 2014 to December 2016.Divided these patients into the bleeding group and the non-bleeding group according to whether there was delayed bleeding after surgery.The age,size of polypus,location of polypus,postoperative pathology of the two groups were compared and the postoperative treatment of bleeding was evaluated.Results Among the 1 243 patients underwent colorectal polypectomy,there were 14 cases of delayed bleeding,and the incidence was 1.13%.In the bleeding group,there was 1 case of secondary delayed bleeding and 2 cases of bloody stool after hemostasis for the delayed bleeding.Delayed bleeding occurred at (4.73±2.49)days after surgery.The predilection site of of polypus was rectum in the bleeding group (7/14,50%), and the diameter of polypus was (16.65±4.91)mm in the bleeding group,which was lager than (8.07±4.23)mm in the non-bleeding group with statistical difference (P<0.05).The proportion of hypertensive and diabetic patients in the bleeding group was significantly higher than that in the non-bleeding group (P<0.05).Juvenile polyps and tubular adenoma with high grade intraepithelial neoplasia were more common in the bleeding group(P<0.05).The bleeding group achieved good hemostatic effect by purse suture,hemostatic clip,electrocautery or injection hemostasis.Conclusion Older age,hypertension and diabetes,lager size of polypus,rectum polypus,juvenile polyps and tubular adenoma with high grade intraepithelial neoplasia were risk factor for delayed bleeding.In the event of delayed bleeding,different choice of purse suture,hemostatic clip,electrocautery or injection hemostasis according to different wounds can achieve the desired effect.
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Objective To evaluate the guidance value of endoscopic ultrasonography (EUS) and CT scan in preoperative clinical staging for diagnosis and treatment of esophageal cancer .Methods 68 patients with esophageal cancer were randomly divided into EUS group and CT group using a random numbers table(34 cases in each group) .Patients in EUS group were examined by EUS , patients in CT group were examined by CT scan ,and staged according to the TNM (2003) staging system ,and were compared with surgical pathologic findings .Results The accuracy rates of T staging by EUS were 0(0/2) for Tis ,75 .0% (3/4) for T1 ,75 .0% (6/8) for T2 ,86 .7% (13/15) for T3 ,80 .0% (4/5) for T4 ,and the totle accuracy rate was 76 .5% (26/34) for T ;those of N staging were 71 .4% (5/7) for N0 ,75 .0% (9/12) for N1 ,0(0/11) for N2 ,0(0/4) for N3 ,and the totle accuracy rate was 41 .2% (14/34) for N .The accuracy rate of T staging by CT scan were 0(0/1) for Tis ,33 .3% (2/6) for T1 ,28 .6% (2/7) for T2 ,78 .6% (11/14) for T3 ,83 .3% (5/6) for T4 and the totle accuracy rate was 58 .8% (20/34) for T ,the difference was statistically significant com-pared with the EUS group(P<0 .05);those of N staging were 77 .8% (7/9) for N0 ,76 .9% (10/13) for N1 ,66 .7% (4/6) for N2 , 50 .0% (3/6) for N3 and the totle accuracy rate was 70 .6% (24/34) for N ,the difference was statistically significant compared with the EUS group (P<0 .05) .Conclusion The accuracy rate of EUS are higher for diagnosis in esophageal cancer and preoperative T staging .The accuracy rate of CT scan are higher for the preoperative N staging .EUS combined with CT scan has great significance for choosing ideal therapy plan for esophageal cancer ,and for estimating prognosis of esophageal cancer .
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<p><b>OBJECTIVE</b>To research the absorbed character of piperine in Erxiekang plaster, and piperine by transdermal absorption was determined.</p><p><b>METHOD</b>The percutaneous absorption of piperine in vitro at different times was conducted by Franz osmosis and diffusion apparatus as well as high-performance liquid chromatography.</p><p><b>RESULT</b>It showed that the piperine through skins of mice gradually increased within the experiment time. After 52 h, the penetration of piperine was 78.51%, and remained basically unchanged.</p><p><b>CONCLUSION</b>The method is reliable, and can be used for Erxiekang plaster of determination of transdermal absorption.</p>
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Animals , Male , Rats , Alkaloids , Metabolism , Benzodioxoles , Metabolism , Linear Models , Piperidines , Metabolism , Polyunsaturated Alkamides , Metabolism , Rats, Sprague-Dawley , Reproducibility of Results , Skin AbsorptionABSTRACT
Objective:To study the best opportunity for minimal invasive puncture in the treatment of hypertensive intracerebral hemorrhage.Methods:Forty-one patients with hypertensive intracerebral hemorrhage were randomly divided into four groups:<6 h,6-12 h,12-18 h and 18-24 h from the onset of symptoms.The comparison among groups in outcome measures were performed,including the rebleeding rate,short-term efficacy,long-term efficacy,mortality,and excellent and good rate.Results:The incidence of complication such as rebleeding etc had no significantly difference in the four groups.The excellent and good rates of clinical outcomes at 3 months were the<6 h group>6-12 h group,and 12-18 h group>18-24 h group(P<0.05).The 18-24 h group had the highest mortality(30%,3/10).Conclusions:Within 6 h after the onset of hypertensive intracerebral hemorrhage was the best opportunity for the minimal invasive puncture.