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ObjectiveThere are many kinds of intestinal cleansing drugs in clinical practice at present, but there is no universal and effective intestinal cleansing program. In this study, sodium polyacrylate was used as a candidate drug for intestinal preparation to explore its feasibility, efficacy and safety for intestinal preparation in mice.Methods24 mice fasted for 12 hours were divided, with random number table method, into 4 groups (6 mice in each): blank group, sodium phosphate group, polyethylene glycol group and sodium polyacrylate solution group. Except that the blank group was given isotonic saline (0.6mL/20g) to fill the stomach, the other groups were given sodium phosphate (0.5mL/20g), polyethylene glycol(0.6mL/20g) and sodium polyacrylate solution (0.6mL/20g) to fill the stomach, and the small intestinal propulsion (carbon powder propulsion), the defecation and intestine volume in mice were observed to explore the effect of sodium polyacrylate on the mice colon cleansing.ResultsAfter administration by gavage for 15min, compared with the blank group [(62.72±6.58) %] and the sodium phosphate group [(66.40±9.53) %], the carbon powder propulsion rate of the sodium polyacrylate solution group [(81.17±4.75) %] significantly increased (P<0.05). The number of fecal excretion [(11.5±2.4) granules] in the sodium polyacrylate solution group after 2 hours of gavage was significantly higher than that in the blank group [(4.5±1.0) granules], the sodium phosphate group [(6.2±2.0) granules] and the polyethylene glycol group [(8.5±1.0) granules] (P<0.05). Compared with the blank group [(39.7±11.60) mg] and the sodium phosphate group [(77.2±15.91) mg], the defecation quality of sodium polyacrylate solution [(162.4±16.69) mg] significantly increased within 2h after gavage (P<0.05). Compared with the blank group [(2.25±0.29)g], the sodium phosphate group [(2.72±0.24)g] and the polyethylene glycol group [(2.95±0.19)g], the intestinal mass of the sodium polyacrylate solution group [(3.30±0.16)g] significantly increased (P<0.05).ConclusionOral administration of sodium polyacrylate solution can accelerate intestinal peristalsis in normal mice, promote defecation in mice, and significantly reduce intestinal absorption of water. As a potential intestinal preparation drug, it has the advantages of small dose, high efficiency, safety and reliability.
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With the development of instruments and the innovation of techniques, gastrointestinal endoscopy is expanding the scope and scale in its application. As an important component of endoscopic therapeutic techniques, the development of endoscopic resection techniques is undoubtedly remarkable. The representative techniques including endoscopic submucosal dissection, submucosal tunneling endoscopic resection and natural orifice transluminal endoscopic surgery have made endoscopic resectable scope gradually extend from the initial intramucosal to the submucosal, and even extraserosal lesions. This article reviews the state of the art and advances of main endoscopic resection techniques.
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With the development of instruments and the innovation of techniques, gastrointestinal endoscopy is expanding the scope and scale in its application. As an important component of endoscopic therapeutic techniques, the development of endoscopic resection techniques is undoubtedly remarkable. The representative techniques including endoscopic submucosal dissection, submucosal tunneling endoscopic resection and natural orifice transluminal endoscopic surgery have made endoscopic resectable scope gradually extend from the initial intramucosal to the submucosal, and even extraserosal lesions. This article reviews the state of the art and advances of main endoscopic resection techniques.
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Gastroesophageal reflux disease (GERD) is defined as refluxing of gastric contents to the esophagus, causing gastrointestinal tract symptoms and/or complications. Proton pump inhibitors are the first choice for the treatment of GERD, but have no such good effect as anti-reflux surgery on refractory GERD. Endoscopic anti-reflux procedures include transoral incisionless fundoplication (TIF), Stretta radiofrequency ablation, anti-reflux mucosectomy (ARMS), and endoscopic injection or implantation. Anti-reflux surgery involves laproscopic Nissen fundoplication (LNF), magnetic sphincter augmentation (MSA), electrical stimulation on the lower esophageal sphincter (LES), and bariatric surgery. This article introduces the progress in anti-reflux surgery for GERD.
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Objective At present,there are a wide range of clinical submucosal injection agents. However,no consensus has been reached on what kind of submucosal injections to use. This study aims to evaluate the feasibility,effectiveness and safety of isopentane as a submucosal injection agent and further provide an evidence for clinical application. Methods Fresh in vitro porcine stomach(In vitro time < 6 h)was used to be submucosal injected with isotonic saline(control group)and isopentane(isopentane group)in 37℃ water bath. We evaluated the injection volume and uplift effect of both submucosal injection agents when the uplift height was 1.5 cm;A 2 cm diameter of mucous uplift was made by isotonic saline or isopentane and then dissected by electrical knife. The opera-tion time was evaluated;20 μL of isotonic saline or isopentane was submucosal injected in living rat stomach. The mucosal uplift height was measured. 1 hour after injection,uplift site(2 mm diameter)was completely dissected by sterile scalpel,bleeding volume was measured within 10 minutes,and the pathological examination of the uplift site was carried out. Results The same height of mucous uplift(1.5 cm)can be achieved by less isopentane[(0.14± 0.07)mL]compared with isotonic saline[(13.65± 4.60)mL],the difference is statistically significant(P<0.01). Isopentane had better uplifting persistency in 5,10,15,20,30,45,60 min(P<0.01).The initial mean uplift area in control group was[(18.10±6.22)cm2],and mean uplift area after 60 min was[(24.24±7.19) cm2],the difference is statistically significant(P=0.03). While isopentane group had a relatively stable uplift area,the mean uplift area was comparable between control group and isopentane group at 0 and 60 min[(22.93± 8.16)cm2vs(21.70± 7.86)cm2,P=0.71]. Similarly,average dissection time was shorter in isopentane group[(3.22±0.53)min]compared with control group[(9.60± 1.98)min](P<0.01). The mucosal thickness variation before and after injection was much more significant in isopentane group than that in control group[(1.34±0.30)mm vs(0.28±0.16)mm,P=0.000]. Conclusion Isopentane submucosal injection can main-tain the effective mucosal uplift height,which is in favor of subsequent endoscopic mucosal resection and has no damage to the tissue. Isopentane is expected to be a new submucosal injection agent.
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<p><b>OBJECTIVE</b>To compare the diagnostic value study the technique of ultrasonography, magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) in common duct stones.</p><p><b>METHODS</b>Three hundreds and eighty-four patients suspected common duct stones from August 2005 to October 2007 were undergone abdominal ultrasonography, MRCP and ERCP.</p><p><b>RESULTS</b>There was stone in common duct in 370 and no stones in 14 of 384 patients. Ultrasonography indicated stones 268 cases, 8 false positive result was among them. MRCP diagnosed stones in 362 cases and false positive result in 6 cases, ERCP diagnosed stones 370 cases. The diagnostic accuracy of ultrasonography, MRCP and ERCP was 70.3% (260/370), 96.2% (356/370) and 100% respectively.</p><p><b>CONCLUSIONS</b>The diagnostic accuracy of ultrasonography for common duct stone was little higher, US should be used as a primary checking method. There was higher concordance between MRCP and ERCP for common duct stone. Combination of MRCP and ERCP can improve diagnostic accuracy of common duct stone.</p>