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Objective:To explore the effect of Helicobacter pylori(HP)eradication on development of metachronous gastric cancer(MGC)after endoscopic submucosal dissection(ESD)in elderly patients with early gastric cancer.Methods:From January 2014 to December 2019, 748 early gastric cancer patients aged 60 years or older, receiving ESD in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, were included.According to the situation of HP infection and eradication efficacy within 1 year postoperatively, patients were divided into three groups.The patients with HP infection and successful HP-eradication were enrolled into successful eradication group, those without eradicating or with eradication failure were enrolled into eradication failure group, those with HP negative were enrolled into HP-negative group.And then the occurrence and risk factors of MGC after ESD among the three groups were statistically analyzed.Results:MGC were detected in 58 cases(7.7%)in elderly patients with early gastric cancer after ESD.The median follow-up time was 39 months.The multivariate regression analysis results of MGC showed that no HP-eradication or HP eradication of failure( HR=2.231, 95% CI: 1.054-4.722, P=0.036)and multiple lesions( HR=1.857, 95% CI: 1.076-3.204, P=0.026)were independent risk factors.Non-smoking was a protective factor for the occurrence of MGC( HR=0.409, 95% CI: 0.234-0.716, P=0.002). After adjusting for confounding factors, Cox proportional risk regression analysis showed that the incidence of MGC was significantly higher in group of no HP-eradicating or HP-eradicating of failure than in group of successful HP-eradicating group( χ2=37.877, P<0.001). Conclusions:HP eradication can effectively prevent MGC in elderly patients with early gastric cancer after ESD.Multiple lesions and smoking are independent risk factors for MGC.
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Objective To analyze the usefulness of homogenate diet when applying for the bowel preparation in electronic colonoscopy. Methods one hundred and eighty patients were selected in Nanjing drum tower hospital from October 2015 to May 2016, including 90 cases in the treatment group and 90 cases in the control group. Using the Boston Bowel Preparation Scale, the intestinal tract cleanness and the adverse reaction between two groups were compared. Results The treatment group was better in the intestinal cleanliness compared with the control group, there was statistical difference (transversostomy:χ2=8.545, P=0.014;left colon:χ2=8.430, P=0.015). Adverse reactions in the treatment group was significantly lower than the control group (χ2=4.305, P=0.004). Conclusions Homogenate diet can guarantee nutrition supply before the preoperative, improve bowel preparation efficiency and reduce the incidence of adverse reactions.