Colonic Endoscopic Tubing Is Safe and Effective Approach for Washed Microbiota Transplantation in Autistic Children.

Background: Washed microbiota transplantation (WMT) as the improved methods of fecal microbiota transplantation has been employed as a therapeutic approach for ameliorating symptoms associated with autism spectrum disorder (ASD). In this context, colonic transendoscopic enteral tubing (TET) has been utilized as a novel procedure for administering WMT. Methods: Data of children with ASD who received WMT by TET were retrospectively reviewed, including bowel preparation methods, TET operation time, success rate, tube retention time, the comfort of children, adverse events, and parent satisfaction. Results: A total of 38 participants underwent 124 colonic TET catheterization procedures. The average time of TET operation was 15 minutes, and the success rate was 100% (124/124). There was no significant difference in TET operation time between high-seniority physicians and low-seniority physicians. In 123 procedures (99%), the TET tube allowed the completion of WMT treatment for 6 consecutive days. In 118 procedures (95.2%), the tube was detached spontaneously after the end of the treatment course, and the average TET tube retention time was 8 days. There was no incidence of tube blockage during the treatment course. No severe adverse events occurred during follow-up. Parents of all participants reported a high level of satisfaction with TET. Conclusion: Colonic TET is a safe and feasible method for WMT in children with ASD.

Washed microbiota transplantation reduces proton pump inhibitor dependency in nonerosive reflux disease.

BACKGROUND: The pathogenesis of gastroesophageal reflux disease (GERD) is closely associated with the intestinal bacteria composition and their metabolites. AIM: To investigate whether washed microbiota transplantation (WMT) improves symptoms of nonerosive reflux disease (NERD) with proton pump inhibitor (PPI) dependency. METHODS: Patients with recurrent NERD and PPI dependency at the First Affiliated Hospital of Guangdong Pharmaceutical University from 2017 to 2018 were included and divided into a WMT or PPI group treated with PPI with/without WMT. The endpoint was NERD symptom frequency evaluated 1 mo after WMT using reflux disease questionnaire (RDQ) and GERD questionnaire (GERDQ) scores, remission time, PPI dose, and the examination of intestinal mucosal barrier function. RESULTS: In the WMT (n = 15) and PPI (n = 12) groups, the total remission rate at 1 mo after treatment was 93.3% vs 41.7%. Compared with the PPI group, the WMT group showed better results in GERDQ (P = 0.004) and RDQ (P = 0.003) and in remission months (8 vs 2, P = 0.002). The PPI dose was reduced to some extent for 80% of patients in the WMT group and 33.3% in the PPI group. In 24 patients, intestinal mucosal barrier function was examined before treatment, and changes in the degree of damage were observed in 13 of these patients after treatment. Only one of the 15 patients had minor side effects, including a mushy stool two or three times a day, which resolved on their own after 1 wk. CONCLUSION: This study is the first to demonstrate that WMT may be safe and effective for relieving NERD symptoms and reducing PPI dependency and recurrence.

Supercapsular percutaneously assisted total hip arthroplasty versus conventional posterior approach: Comparison of early functional results.

OBJECTIVE: This study aimed to explore the early functional results of total hip arthroplasty (THA) using the supercapsular percutaneously assisted total hip (SuperPATH) microposterior approach. METHODS: In this retrospective study, 58 patients treated with THA from October 2015 to April 2016 in our hospital were enrolled. A total of 28 patients (11 men and 17 women; mean age: 74.95±7.06 years) were operated on using the SuperPATH approach (group 1), and the remaining 30 patients (12 men and 18 women; mean age: 75.63±7.89 years) were operated on using the conventional posterior approach (group 2). To summarize the early functional results of the SuperPATH approach, we retrospectively analyzed the following demographics, perioperative factors, and measures of joint function: age, sex, preoperative diagnosis, preoperative visual analog scale (VAS) for pain, body mass index, the American Society of Anesthesiologists physical status, operation time (skin-to-skin), intraoperative bleeding, incision length, postoperative VAS, Harris Hip Score (HHS), Barthel Index (BI), length of hospital stay, positioning of the implants, and postoperative complications. RESULTS: All 58 operations were successfully completed, and the average follow-up time was 45 (45.03±2.44) months. The patients in group 1 had shorter incision length (8.84±0.59 versus 13.26±2.41 cm) and length of stay (7.86±0.51 versus 10.80±1.93 days), lower postoperative VAS score (2.43±0.69 versus 3.13±0.94), and better postoperative HHS (88.37±4.31 versus 83.81±6.00) and BI (91.47±5.27 versus 83.59±6.83) at 3 months than the patients in group 2; however, group 1 patients had longer operation time (113.95±25.36 versus 87.22±25.43 min) than group 2 patients (all P<0.05). No significant intergroup differences were found with respect to intraoperative bleeding, cup abduction angle, anteversion angle, and stem positioning. During the follow-up, no deep venous thrombosis, postoperative infection, and hip dislocation were observed in any patient. CONCLUSION: Compared with the conventional posterior approach, the SuperPATH approach provided better early functional results with less postoperative pain and shorter hospitalization time. However, the operation time was longer in the SuperPATH approach group. LEVEL OF EVIDENCE: Level III, Therapeutic study.