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BACKGROUND@#To investigate the effectiveness of topical application of 4% formaldehyde as a minimally invasive treatment of rectal bleeding due to chronic radiation proctitis (CRP) under direct vision of electronic colonoscope.@*METHODS@#The clinical data of 13 CRP patients complicated with ≥ grade II bleeding admitted to our hospital between January 2003 and December 2018 were retrospectively analyzed. Under the guidance of electronic colonoscope, 4% formaldehyde combined with 5-aminosalicylic acid (5-ASA) suppositories was topically applied. Patients were followed up for two months after treatment, and the therapeutic effectiveness was observed and analyzed.@*RESULTS@#The rectal bleeding due to CRP was markedly reduced after topical application of 4% formaldehyde under colonoscope in all 13 patients. The bleeding stopped after one treatment session in 11 patients and after the second session in 2 patients. 5-ASA was also applied along with the use of 4% formaldehyde. The therapeutic effectiveness was satisfactory during the 1- and 2-month follow-up period.@*CONCLUSION@#Topical application of 4% formaldehyde under the direct vision of colonoscope as a minimally invasive treatment for CRB-induced bleeding is a simple, effective, affordable, and repeatable technique without obvious complications, which deserves further exploration and promotion.
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Purpose To investigate the expression of Orai1 and STIM1 in colon cancer and its clinical significance.Methods Immnohistochemistry was used to detect Orai1 and STIM1 protein expression level in 80 cases of colon cancer and 50 cases of normal colon epithelium.The relationships between Orai1 and STIM1 expression and prognosis were statistically analyzed.Result The expression levels of Orai1 and STIM1 in colon cancer were significantly higher than that in normal colon epithelium(P＜ 0.05).Positive expression of Orai1 and STIM1 was correlated with the TNM stage and lymph node metastasis (P ＜ 0.05),but not correlated with gender,age,and differentiation(P ＞0.05).There was a significant positive correlation between Orai1 and STIM1 expression(P =0.001,rs =0.349).Univariate analysis showed that the expression of Orai1 protein,STIM1 protein,TNM stage and lymph node metastasis were significant prognostic factors for colon cancer patients.Conclusion In colon cancer,both Orail and STIM1 proteins may have synergetic functions and promote the development of the tumor,and could be used as a novel biological indicator of anticancer therapy and prognosis.
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<p><b>BACKGROUND</b>Awake fiberoptic intubation (AFOI) is usually performed in the management of the predicted difficult airway. The aim of this study was to evaluate the feasibility of dexmedetomidine with midazolam (DM) and sufentanil with midazolam (SM) for sedation for awake fiberoptic nasotracheal intubation.</p><p><b>METHODS</b>Fifty patients with limited mouth opening scheduled for AFOI were randomly assigned to two groups (n = 25 per group) by a computer-generated randomization schedule. All subjects received midazolam 0.02 mg/kg as premedication and airway topical anesthesia with a modified "spray-as-you-go" technique. Group DM received dexmedetomidine at a loading dose of 0.5 μg/kg over 10 min followed by a continuous infusion of 0.25 μg·kg-1·h-1, whereas Group SM received sufentanil at a loading dose of 0.2 μg/kg over 10 min followed by a continuous infusion of 0.1 μg·kg-1·h-1. As necessary, since the end of the administration of the loading dose of the study drug, an additional dose of midazolam 0.5 mg at 2-min intervals was given to achieve a modified Observers' Assessment of Alertness/Sedation of 2-3. The quality of intubation conditions and adverse events were observed.</p><p><b>RESULTS</b>The scores of ease of the AFOI procedure, patient's reaction during AFOI, coughing severity, tolerance after intubation, recall of the procedure and discomfort during the procedure were comparable in both groups (z = 0.572, 0.664, 1.297, 0.467, 0.895, and 0.188, respectively, P > 0.05). Hypoxic episodes similarly occurred in the two groups, but the first partial pressure of end-tidal CO2after intubation was higher in Group SM than that in Group DM (45.2 ± 4.2 mmHg vs. 42.2 ± 4.3 mmHg, t = 2.495, P < 0.05).</p><p><b>CONCLUSIONS</b>Both dexmedetomidine and sufentanil are effective as an adjuvant for AFOI under airway topical anesthesia combined with midazolam sedation, but respiratory depression is still a potential risk in the sufentanil regimen.</p>