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Objective:To compare the efficacy of domestic and imported hemostatic clips in preventing delayed post-polypectomy bleeding (DPPB) after endoscopic resection of colorectal polyps ≥ 10 mm.Methods:Clinical data of 789 patients who underwent endoscopic resection of colorectal polyps (polyp diameter ≥10 mm) in Beijing Friendship Hospital, Capital Medical University from January 2018 to December 2019 were collected. The patients were divided into DPPB group ( n=15) and non-DPPB group ( n=774). Univariate and multivariate logistic regression models were used to analyze the influential factors for DPPB. The patients using one type of hemostatic clip were divided into the domestic hemostatic clip group ( n=499) and the imported hemostatic clip group ( n=208). The efficacy of hemostatic clips in preventing DPPB in the two groups was compared. Results:Among the 789 patients undergoing endoscopic resection of colorectal polyps, 1.9% (15/789) suffered from DPPB. Multivariate logistic regression analysis showed that pedunculated polyp was an independent risk factor for DPPB ( OR=6.621, 95% CI: 2.278-19.241, P=0.001), and closure of mucosal defect was an independent protective factor for DPPB ( OR=0.169,95% CI: 0.050-0.570, P=0.004). Regardless of physician experience, there was no significant difference between the domestic and imported hemostatic clip group in preventing DPPB after endoscopic resection of colorectal polyps ≥10 mm [experienced physicians: 1.8% (7/385) VS 0.6% (1/175), χ2=1.314, P=0.445; common physicians: 2.6% (3/114) VS 3.0% (1/33), χ2=0.010, P>0.999]. The domestic hemostatic clip group paid for less medical expenses than the imported hemostatic clip group (experienced physicians: 1 433.51±889.02 yuan VS 3 033.97±1 686.87 yuan, t<0.001 , P<0.001; common physicians: 1 181.58±815.29 yuan VS 3 303.46±1 690.43 yuan, t<0.001 ,P<0.001). Conclusion:Pedunculated polyp is an independent risk factor for DPPB after endoscopic resection of colorectal polyp larger than 10 mm, and clipping can significantly reduce the risk for DPPB. There is no significant difference in the prevention of DPPB between domestic and imported clips, but domestic clips compared with imported clips yield less medical burden, which are suitable for promotion to primary hospitals and major clinical centers.
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Objective:To analyze the risk factors for the most common adverse events, i.e. abdominal pain and distension in sedation-free colonoscopy.Methods:This was a multicenter clinical study, in which clinical data of patients including outpatients and inpatients who underwent selective sedation-free colonoscopy at six gastrointestinal endoscopy centers from July 2017 to December 2019 were collected, including patients' general information, complicating diseases, examination time, examination results, and occurrence of adverse events of abdominal pain and distension. Univariate and multivariate logistic regression was performed to analyze the risk factors for adverse events of abdominal pain and distension during sedation-free colonoscopy.Results:A total of 2 394 patients underwent sedation-free colonoscopy, among whom 690 (28.8%) suffered from abdominal pain, and 1 151 (48.1%) experienced abdominal distension. The results of multivariate logistic analysis showed that overweight ( OR=1.33, 95% CI:1.09-1.62, P=0.005), obesity ( OR=1.55, 95% CI:1.14-2.11, P=0.005) and combination of hypertension ( OR=1.58, 95% CI:1.23-2.02, P<0.001) were independent risk factors for abdominal pain during sedation-free colonoscopy, and overweight ( OR=1.40, 95% CI:1.17-1.68, P<0.001) and combination of hypertension ( OR=1.39,95% CI:1.10-1.76, P=0.006) were independent risk factors for abdominal distension during sedation-free colonoscopy. Conclusion:Obesity, overweight and combination of hypertension are independent risk factors for abdominal pain, and overweight and combination of hypertension are independent risk factors for abdominal distension during sedation-free colonoscopy.
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From January 2016 to December 2020, 6 cases of polyps in the appendix cavity with a diameter of 0.3-1.3 cm were treated by endoscopy in the Department of Gastroenterology of Beijing Friendship Hospital, Capital Medical University. All 6 cases underwent endoscopic treatment successfully, including 3 cases of en bloc endoscopic mucosal resection (EMR), 1 case of piecemeal EMR, 1 case of endoscopic submucosal dissection (ESD), and 1 case of removed by cold forceps. No complications such as bleeding, perforation, infection or acute appendicitis occurred.The wound healed well with no recurrence after re-examination in 3 cases, and 3 others were not re-examined by colonoscopy yet. The results preliminarily confirmed that endoscopic treatment of intraluminal polyps in the appendix cavity is safe and effective.
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Objective@#To screen the changes of microRNA (miRNA) expression profiles in lung tissues of early silicosis rats, and provide a basis for functional analysis of differential microRNA.@*Methods@#SPF Wistar male rats were randomly divided into a negative control group and SiO2-exposed groups, with 30 rats in each group. The model of silicosis in rats was established by intratracheal instillation of 1 ml SiO2 suspension, and the control rats were treated with 1mL in the same way to sterilize normal saline. The lung tissues of two group were collected at the 1, 7, 14, 21, 28 d after SiO2-exposed. Three of the rat lung tissues were used for pathological observation, and the other three were used to screen differentially expressed miRNAs in lung tissue by miRNA microarray technology. miRNA chip screening and RT-qPCR were used to verify the expression levels of miRNA-423-5p and miRNA-26a-5p in the two groups. miRNA-423-5p and miRNA-26a-5p are predicted by target genes and analyzed by GO (gene ontology) enrichment analysis and KEGG (kyoto encyclopedia of genes and genomes) pathway analysis.@*Results@#In the control group, the inflammatory response of lung tissue 21 and 28 days was significantly reduced compared with 1, 7 and 14 days, and the inflammatory cells infiltrated in the lung tissue of the SiO2-exposed rats. The rats in the control group had a small amount of collagen at 21 and 28 days, but a large amount of collagen fiber deposition began to appear in the lung tissue of rats exposed to SiO2 after 21 days. Compared with the control group, the expression levels of micro RNA-423-5p was significantly up-regulated and the expression of microRNA-26a-5p was significantly down-regulated in the SiO2-exposed rats lung tissues dust at different time points (P<0.05) .@*Conclusion@#The up-regulation of miRNA-423-5p and the down-regulation of miRNA-26a-5p in lung tissues of early silicotic rats may be related to the occurrence and development of early silicosis.
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Objective To investigate the pancreas size and echo characteristics of patients with glucose metabolism disorders including type 2 diabetes,and to study its related factors.Methods One hundred and fifty-seven patients from Nanjing Drum Tower Hospital with normal glucose metabolism,impaired glucose regulation,newly diagnosed type 2 diabetes and established type 2 diabetes were collected.The average gray scale intensity of the liver,kidney,pancreas region of interest was measured by using the histogram method.Then the liver and kidney echo ratio,liver attenuation coefficient was calculated,and the fat content of liver was determined by using formula.The size of pancreas head,body and tail was detected by ultrasound,and the sum of three values was used as the pancreas size indicator.Univariate and multivariate logistic regression analysis was performed on the size of pancreas and intensity of echo.Results The size of pancreas ranged from 2.39 ～ 6.09 cm with a mean size of (4.43 ± 0.59) cm,and the size was ≤ 5 cm in 130patients,＞5 cmin 27 patients.The intensity of echo ranged from 41.0 ～ 190.6 with a mean number of 120.0 ±31.1,and the intensity of echo was ≤120 in 83 patients,＞ 120 in 74 patients.The content of liver fat ranged from-1.11％ ～ 62.50％ with a mean number of (15.67± 11.97)％.Univariate logistic regression analysis suggested the size of pancreas was related to age and obesity,and pancreas echo was related to obesity degree,types of participants,the level of blood glucose,and grade of fatty liver (all P ＜ 0.05).Multivariate logistic regression analysis indicated obesity degree is the most important factor for prediction of pancreas size and echo (P ＜ 0.05).Conclusions Quantitative ultrasound measurement of pancreas size and echo can reflect the degree of fat infiltration of pancreas,and it has some clinical value.
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Objective To observe the efficacy and safety of huperzine A combined with memantine in patients with Alzheimer disease (AD).Methods Sixty-five cases of AD were randomly divided into control group(32 cases) and treatment group(33 cases) by order of admission.The patients in control group were given memantine.The patients in treatment group were given huperzine A combined with memantine.The efficacy and safety was observed and compared between two groups.Results The mini-mental state examination score after treatment of 24 weeks in treatment group was higher than that in control group [(17.9 ± 1.8) scores vs.(16.2 ± 1.2) scores,P ＜ 0.05].The AD assessment scale of cognitive scale score after treatment of 24 weeks in treatment group was lower than that in control group [(19.9 + 4.8) scores vs.(22.2 ± 5.2) scores,P ＜ 0.05].The superoxide dismutase level after treatment of 24 weeks in treatment group was higher than that in control group [(102.4 ± 2.3) U/L vs.(95.4 ± 7.6) U/L,P ＜ 0.05].The neuron-specific enolase level after treatment of 24 weeks in treatment group was lower than that in control group [(6.3 ± 1.2)μ g/L vs.(7.4 + 1.4)μ g/L,P ＜ 0.05].During treatment,patients showed no serious adverse reactions.Conclusion Huperzine A and memantine has synergistic effects,the combined treatment in AD is safe and reliable.
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The QCC campaign at the emergency center was themed as minimizing incidence of risky transport of critically ill patients,which aimed at continued quality improvement by means of conditions review,problem analysis,measures making,and procedure improvement.The incidence of risky transports dropped from 26％ to 0.9％ in six months.Another promising outcome was a sharp betterment of clinical nurse management. It has proved that QCC can effectively downsize risky transports of critically ill patients,making it a functional means to improve nursing quality.