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Objective:To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) after pancreaticoduodenectomy and endoscopic selection strategies.Methods:Clinical data of 34 patients treated with ERCP after pancreaticoduodenectomy at the Endoscopic Center of the First Affiliated Hospital of Air Force Medical University from January 2013 to December 2021 were retrospectively analyzed. The success rates of endoscopic insertion, diagnosis, treatment and ERCP, and the incidence of adverse events were analyzed.Results:Fifty ERCP treatments were performed in 34 patients. The success rates of endoscopic insertion, diagnosis, treatment, and ERCP after pancreaticoduodenectomy were 92.0% (46/50), 93.5% (43/46), 88.4% (38/43) and 76.0% (38/50), respectively. The success rates of ERCP assisted with colonoscope and balloon-assisted enterosocpe were 76.0% (19/25) and 75.0% (18/24), respectively. There were 3 adverse events, including 1 case of anastomotic mucosa tear during surgery, 1 case of cardiopulmonary arrest and 1 case of postoperative cholangitis.Conclusion:ERCP is effective and safe after pancreaticoduodenectomy in general. ERCP assisted with colonoscope and balloon-assisted colonoscope shows similar success rate after pancreaticoduodenectomy.
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Objective:To investigate the risk factors of dysplasia in patients with ulcerative colitis (UC) in China.Methods:From March 1st, 2012 to December 30th, 2013, a total of 154 UC patients were prospectively enrolled from the following 11 hospitals, Xijing Hospital of Digestive Diseases, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Peking Union Medical College Hospital, Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Nanfang Hospital affiliated to Southern Medical University, China-Japan Friendship Hospital, The Second Hospital of Hebei Medical University, West China Hospital affiliated to Sichuan University, The Seventh Medical Center of PLA General Hospital, Zhongshan Hospital affiliated to Xiamen University, and the First Affiliated Hospital of Anhui Medical University. The patients were followed up till December 1st, 2017. All the UC patients underwent colon endoscopy and histopathological evaluation. T test and Chi-square test were used for statistical analysis. Cox proportional risk model was used for identifying the risk factors of dysplasia in UC patients. Results:Finally, 133 UC patients were enrolled, the age was (50.0±11.9) years, the diagnosis age was (35.5±11.6) years, the course of disease was (14.5±6.7) years, and the number of endoscopic examinations was (3.4±1.6) times. A total of 21 patients were detected with dysplasia. No patients were detected with colorectal cancer. The results of univariate analysis revealed that the diagnosis age (hazard ratio ( HR)=1.05, 95% confidence interval ( CI) 1.01 to 1.10, P=0.009) and extensive colitis ( HR=2.92, 95% CI 0.97 to 8.79, P=0.057) were factors with statistically significant difference. The results of multivariate analysis revealed that the old age at diagnosis ( HR=1.06, 95% CI 1.02 to 1.11, P=0.003) and extensive colitis ( HR=3.68, 95% CI 1.21 to 11.19, P=0.022) were independent risk factors of dysplasia in UC patients. The cumulative incidence of dysplasia of UC patients with extensive colitis was higher than that of patients with left-sided colitis (24.3%, 17/70 vs. 6.3%, 4/63), and the difference was statistically significant ( χ2=8.023, P=0.005). Conclusions:Extensive colitis and older age at diagnosis are two independent risk factors of dysplasia in UC patients of our country. The cancer monitoring should be strengthened in UC patients with long course of disease and extensive colitis.
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Objective To investigate whether Tian Jiu therapy can regulate Th1/Th2 ratio effectively for bronchial asthma patients.Methods A total of 30 bronchial asthma patients who were treated with Tian Jiu therapy in the hospital were enrolled in the study as patients group and 20 healthy individuals were enrolled as control group.The mRNA of T-bet,GATA3,Foxp3 and STAT-6 were detected by using realtime-PCR,while IFN-γ and IL-4 were detected by using ELISA for control group and patents group before and after treatment. Flow cytometry was used to detect Th1/Th2 ratio.Results After Tian Jiu therapy,Th2 proportion decreased and Th1/Th2 ratio increased,secretion of IFN-γ decreased,mRNA of T-bet and GATA3 significantly in-creased,while STAT-6 decreased significantly(P<0.05).Conclusion Tian Jiu therapy has therapeutic effect on bronchial asthma patients through decreasing Th2 proportion and regulating Th1/Th2 ratio.
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Gastric cancer is one of the common malignant tumors in digestive system. The incidence of gastric cancer in China is higher than that in developed countries. The prognosis of gastric cancer is closely related to the stage of cancer, and the prognosis of advanced gastric cancer is poor. Improving the detection rate of early gastric cancer is the key to improve the survival of patients with gastric cancer. Endoscopic technology developed rapidly in recent years,various forms of endoscopy have been applied in clinical practice,and the detection rate of early gastric cancer was increased. This article reviewed the advances in study on endoscopic diagnosis of early gastric cancer.
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Objective To develop an MR optical dual-modality probe targeting angiogenesis of gastric cancer and to study its physical characteristics , in vitro cytotoxicity and magnetic effects of different pulse sequences on 3 T clinical MR scanner.Methods We conjugated GX1-Cy5.5, a novel gastric cancer neo-vasculature targeted peptide labeled with Cy 5.5, to the surface functionalized magnetic nanoparticles according to different molecular weights (1∶100, 1∶500),resulting in dual-modality probe DPs100 and DPs500 (named DPs).The hydrodynamic size and zeta potential of DPs and DPs 500 were analyzed by nano-ZS.The human umbilical vein endothelial cells (HUVECs) and BGC-823 cells were treated with DPs for 24 h, and methyl thiazol tetrazolium ( MTT) method was used to detect the survival rate of cells.DPs with different concentrations were scanned on different MR sequences , and then the relative signal intensity was observed.The absorbance of HUVECs and BGC823 cells treated with DPs of different concentration (0.00, 1.25, 2.50, 15.00, 50.00, 100.00 and 150.00 μg/ml) were compared with single factor analysis of variance.Relative signal intensity of different MR sequences was compared using a paired Wilcoxon signed-rank test.Results The dual-modality probe targeting angiogenesis of gastric cancer was successfully constructed.The hydrodynamic size of iron oxide nanoparticles , DPs100 and DPs500 was (35.23 ±0.07), (39.49 ±0.16) and (40.43 ±1.70) nm and the Zeta potential was (0.31 ±0.20), ( -4.15 ±0.79) and ( -10.51 ± 2.37) mV.The coupled rates of DPs 100 and DPs500 with polypeptide were 92%and 94% respectively.The absorbance of HUVECs and BGC823 cells treated with DPs of different concentrations were 0.76 ±0.04, 0.80 ±0.03, 0.79 ±0.05, 0.75 ±0.06, 0.74 ±0.05, 0.77 ±0.01,0.71 ±0.04 and 0.38 ±0.04, 0.43 ±0.04, 0.41 ±0.03, 0.43 ±0.07, 0.44 ±0.04, 0.41 ±0.07 and 0.40 ±0.04, there was no statistical significance ( F=0.94, 0.51;P>0.05).The signal intensity increased first and then decreased following the increasing concentrations of DPs on T 1WI,especially on FSPGR T1WI (Z =-3.294,P 10μg/ml( Z=-7.110,P>0.05).With iron concentration≤10 μg/ml,the signal intensity on SSFSE T 2*WI was significantly decreased compared to FSE T2 WI ( Z =-2.023, P <0.05 ) .Conclusions DPs may be potential dual-modal probes for characterization of tumor angiogenesis by MR and optical imaging noninvasively , without causing significant effects on the cell activity in vitro , and SSFSE T2*WI may be the most sensitive sequence for DPs evaluation on MR.
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Objective To investigate the etiology and clinical characters of ileocecal inflammatory mass and to improve the diagnosis and therapy of ileocecal inflammatory mass.Methods From July 2006 to July 2011,the data of ileocecal inflammatory mass cases were collected,including disease history,clinical manifestations,complications,imaging results,colonscopy results,pathological results and diagnosis.The clinical characters were summarized.Results A total of 241 cases with ileocecal inflammatory mass were collected and 83 cases of them were Crohn's disease,79cases were appendicitis with periappendiceal abscess,54 cases were intestinal tuberculosis,eight cases were intestinal malignant lymphoma and 17 cases were undefined.The main manifestations of 85patients were abdominal pain,right inferior abdominal mass and fever,among which 56 patients were Crohn's disease.Among 90 patients with surgical operation,44 patients were Crohn's disease,among which 12 patients received operation because of appendicitis with periappendiceal abscess at first while the pathological examination after operation for the recurrence of ileocecal inflammatory masses proved Crohn's disease.During the course of disease,69 cases had complications of intestinal obstruction,in whom 44 cases were Crohn's disease.Nine cases had intestinal fistula,24 cases had upper gastrointestinal ulcers,one case had impetigo,and all of the above cases were Crohn's disease.Conclusions The common etiologies of ileocecal inflammatory mass were Crohn's disease.Ileocecal inflammatory mass recurrence after surgery,ileocecal inflammatory mass complicated with intestinal obstruction and abenteric manifestations were more common in Crohn's disease.
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Objective To compare the efficacy and safety of 5-fluorouracil and calcium folinatc combined with oxaliplatin (FOLFOX) program with capecitabine regimen combined oxaliplatin (XELOX) program as adjuvant chemotherapy in advanced colorectal cancer after surgery.Methods The postoperative clinical data of 286 advanced colorectal cancer patients were retrospectively analyzed.Of which,204 patients received FOLFOX4/6 adjuvant chemotherapy and 82 patients received XELOX adjuvant chemotherapy.The three-years disease-free survival (DFS) time,three-years overall survival (OS) time and adverse reactions of the two groups were compared.Count data of the two groups' were compared by chi-square test,and measurement data were analyzed by t-test.Results In the FOLFOX4/6 group,153 patients (75 ％) completed 12 cycles of chemotherapy,and in the XELOX group,66 patients (80 ％) finished eight cycles of chemotherapy.There was no statistical difference in three-year DFS incidence (FOLFOX4/6 stage Ⅱ 87％,Ⅲ 82％; XELOX stage Ⅱ 83％,Ⅲ 80％) and three-year OS incidence (FOLFOX4/6 stage Ⅱ 92％,Ⅲ 88％; XELOX stage Ⅱ 89％,Ⅲ 86％) between two groups (all P＞0.05).There was no statistical difference in the incidence of common adverse reactions between FOLFOX4/6 and XELOX group (all P＞0.05).Adverse reactions of degree Ⅰ and Ⅱ were more common,while degree Ⅲ and Ⅳ were seldom.Of the adverse reactions of degree Ⅲ and Ⅳ,the incidence of neutropenia in patients of FOLFOX group was a little higher than in those of XELOX group,and the incidence of hand-foot syndrome was a litter higher in XELOX group than in FOLFOX group.However,there was no significant difference (x2 =0.060,0.928,both P＞0.05).Conclusion There was no statistical significance between FOLFOX4/6 and XELOX as postoperative auxiliary chemical therapy for advanced colorectal cancer,and both therapies possess good tolerance and safety.