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Objective:To compare the histopathological features and treatment efficacy of different methods for metachronous early gastric cancer (MEGC) in the remnant stomach.Methods:A total of 66 patients [38 endoscopic submucosal dissection (ESD) and 28 gastrectomy] with MEGC in the remnant stomach from January 2014 to December 2020 in Drum Tower Hospital were divided into the ESD group and the gastrectomy group. The baseline characteristics, histopathological features, treatment efficacy, and cost differences of the two groups were analyzed.Results:The MEGC in the remnant stomach mostly occurred in elderly male patients, with the mean age of 69.7±8.5 years. The mean interval of the occurrence of MEGC in the remnant stomach was 6 years. As for the tumor location, the gastric body (31.6%) was the main location in the ESD group and gastric cardia (53.6%) in the gastrectomy group with significant difference ( χ2=11.07, P=0.026). The mean operation time, hospital stay, postoperative fasting time, and total treatment cost were 80.0 min, 6.0 d, 1.5 d, ￥19 436 in the ESD group and 215.0 min, 19.0 d, 6.5 d, and ￥68 665 in the gastrectomy group, respectively, with significant differences between the two groups ( P<0.05). The overall survival rate during follow-up was 76.3% in the ESD group and 71.4% in the gastrectomy group with no significant difference between the two groups ( χ2=0.736, P=0.778). In terms of postoperative complications, the incidences of bleeding and infection were 7.9% and 5.3% in the ESD group, and those of obstruction and infection were both 14.3% in the gastrectomy group. There was significant difference in the incidences of postoperative obstruction between the two groups ( P<0.05). Conclusion:ESD is safe and effective for MEGC in the remnant stomach and is better than gastrectomy in terms of the treatment cost and operation time, but the long-term efficacy still needs to be validated by large-scale prospective studies.
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Objective:To summarize the research progress of domestic nurses′ turnover intentions in the past ten years, and to provide references for related research on improving nurses′ turnover intentions.Methods:In May 2021, the documents related to nurses′ resignation intentions were retrieved in China National Knowledge Infrastructure (CNKI), Wanfang and VIP database and Citespace5.7.R5 software was used to perform keyword visualization analysis to form keyword clustering graphs and tables, emergent words, and corresponding time zones figure, the current research status and hot trends of nurses′ turnover intentions were analyzed.Results:A total of 2 029 valid documents were retrieved, the number of publications reached the highest peak in 2019. Among them, "nurse", "willingness to leave", "job satisfaction", "turnover intention" and "influencing factors" were the top 5 hot keywords and 23 emergent words were generated; research directions mainly included influencing factors and research objects and workplace related topics.Conclusions:Managers should actively play a leadership role to reduce nurses′ turnover intention through various effective intervention studies.
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Objective:To evaluate the short-type single balloon enteroscope (SBE) to endoscopic retrograde cholangiopancreatography (ERCP) in patients with Roux-en-Y anastomosis.Methods:Data of 10 patients with Roux-en-Y anastomosis who received short-type SBE assisting ERCP (14 times of ERCP, the short-type SBE group) from May 2019 to September 2019 and 55 patients who received conventional SBE assisting ERCP (87 times of ERCP, the conventional SBE group) from March 2016 to April 2019 were collected in Nanjing Drum Tower Hospital. Success rates and mean time of reaching the blind loop, diagnosis and treatment success rates, procedure time and complication incidence in the two groups were compared.Results:The mean time to reach the blind loop was significantly shorter in short-type SBE group than that in the conventional SBE group (17.1 min VS 23.4 min, P = 0.04). There were no significant differences in success rates of reaching the blind loop[100.0%(14/14) VS 95.4%(83/87)], the success rates of diagnosis and treatment[both 100.0% (14/14) VS 100.0% (83/83)], the mean procedure time (62.6 min VS 64.3 min) or complication incidence [21.4%(3/14) VS 16.1% (14/83) ] between the two groups (all P>0.05). Conclusion:ERCP assisted by either type of SBE is safe and effective in patients with Roux-en-Y anastomosis. However, short-type SBE is faster to reach the blind loop because of its unique design and easier manipulation.
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Objective To assess the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) for children with pancreaticobiliary diseases. Methods Data of children under 14 years old who have underwent ERCP in Nanjing Drum Tower Hospital between September 2007 and August 2016 were reviewed for completion, complications and therapeutic methods. Results A total of 41 children underwent 68 ERCP, including 6(8. 8%) diagnostic and 62(91. 2%) therapeutic procedures. All procedures were performed under deep sedation. Cannulation failed in only 1 child with anomalous junction of pancreaticobiliary duct. The procedure success rate was 98. 5%( 67/68 ) . There were 8 adverse events, including 7 mild post?ERCP pancreatitis and 1 fever. Incidence of adverse event was 11. 8%( 8/68) . There was no such severe adverse event as bleeding, perforation, death, or other anesthesia related adverse event. Thirty?two children ( 78. 0%) had follow?up, ranging from 2 month to 6 years. Children followed lived well with no long?term adverse event. Conclusion ERCP is an effective and safe procedure for the diagnosis and treatment of pancreaticobiliary diseases in children.
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Background:Pyruvate kinase M2( PKM2 ),which is highly expressed in cancer cells,plays an important role in cancer cell growth and aerobic glycolysis and is a promising target for cancer therapy. Aims:To investigate the effect of silencing PKM2 by siRNA on proliferation,apoptosis,migration,invasion and glycolysis of gastric cancer cell line SGC-7901 cells. Methods:SGC-7901 cells were divided into three groups:non-transfectd SGC-7901 cells,SGC-7901 cells transfected with empty plasmid and SCG-7901 cellls transfected with PKM2 siRNA. Expression of PKM2 was detected by fluorescent quantitative PCR and Western blotting at mRNA and protein levels. Intracellular expression and distribution of PKM2 was determined by immunofluorescence. CCK-8 assay,flow cytometry,migration and invasion experiment were used to assess cell proliferation,apoptosis,migration and invasion,respectively. Western blotting was used to determine the expression of glucose transporter-1( Glut-1)and lactate dehydrogenase A( LDHA). Spectrophotometry was used to detect levels of extracellular glucose and lactic acid and intracellular lactate dehydrogenase( LDH). Results:Compared with non-transfected group and negative control( empty plasmid )group,PKM2 mRNA and protein expressions were significantly decreased in PKM2 siRNA plasmid transfected group(P<0. 05). Intracellular expression of PKM2 was markedly decreased in PKM2 siRNA cells. After transfected with PKM2 siRNA plasmid,cell proliferation,migration and invasion were significantly inhibited,and cell apoptosis was increased significantly( P<0. 05 ). Expressions of Glut-1 and LDHA were down-regulated in PKM2 silenced cells( P <0. 05 ). Glucose uptake,lactic acid production and LDH activities were significantly decreased in PKM2 silenced cells(P<0. 05). Conclusions:RNA interference targeting PKM2 gene inhibits PKM2 expression in human gastric adenocarcinoma cell line SGC-7901 cells,thereby inhibits cell proliferation and glycolysis.