Cap-assisted endoscopic sclerotherapy for hemorrhoids: Methods, feasibility and efficacy.

AIM: To evaluate the methodology, feasibility, safety and efficacy of a novel method called cap-assisted endoscopic sclerotherapy (CAES) for internal hemorrhoids. METHODS: A pilot study on CAES for grade I to III internal hemorrhoids was performed. Colon and terminal ileum examination by colonoscopy was performed for all patients before starting CAES. Polypectomy and excision of anal papilla fibroma were performed if polyps or anal papilla fibroma were found and assessed to be suitable for resection under endoscopy. CAES was performed based on the requirement of the cap, endoscope, disposable endoscopic long injection needle, enough insufflated air and sclerosing agent. RESULTS: A total of 30 patients with grade I to III internal hemorrhoids was included. The follow-up was more than four weeks. No bleeding was observed after CAES. One (3.33%) patient claimed mild tenesmus within four days after CAES in that an endoscopist performed this procedure for the first time. One hundred percent of patients were satisfied with this novel procedure, especially for those patients who underwent CAES in conjunction with polypectomy or excision of anal papilla fibroma. CONCLUSION: CAES as a novel endoscopic sclerotherapy should be a convenient, safe and effective flexible endoscopic therapy for internal hemorrhoids.

[Antiviral effects of dual-target antisense rna: an experimental study with hepatitis B virus transgenic mice].

OBJECTIVE: To investigate the curative effects of dual-target antisense RNA targeting the X and P regions in the genome of hepatitis B virus (HBV). METHODS: Retrovirus vector pLXSN was used to construct 4 kinds of recombinant vector plasmids expressing dual-target antisense RNA complementary to the X and P regions in the genome of HBV, namely, pLXSN-asX, pLXSN-asP, pLXSN-asXP, and pLXSN-seX. 48 HBV transgenic mice were randomly divided into 6 equal groups: pLXSN-asX group, pLXSN-asX group, pLXSN-asX group, pLXSN-asX group, and blank plasmid blank (pLXSN) group, to be injected into the caudal vein with corresponding plasmids thrice for every other day, and blank control group. Venous blood samples were collected before, 1 day and 3 days, and 2, 4, and 8 weeks after the injection to undergo detection of serum HBV DNA and HBsAg. Eight weeks later the mice were killed and immunohistochemistry was used t examine the HBsAg and HBcAg in the tissues. Pathological examination of the tissues was performed. RESULTS: The serum HBsAg concentrations 4 and 8 weeks after injection were significantly lower than that before injection in the.pLXSN-asX and pLXSN-asXP groups (all P <0.05) with an inhibition rate of 24% and 27% respectively. In comparison with that before injection, the HBV DNA expression level 2 weeks after injection was significantly lower in the pLXSN-asX group (P < 0.05) with an inhibition rate of 58%. In comparison with that before injection, the HBV DNA expression level 8 weeks after injection was significantly lower in the pLXSN-asP group (P <0.05) with an inhibition rate of 58%. In comparison with that before injection, the HBV DNA expression level in the pLXSN-asXP group showed 2 times of significant decrease 1 week and 8 weeks after injection (both P < 0.05) with the inhibition rates of 66% and 77% respectively. HBsAg and HBcAg were expressed in liver were significantly lower in the pLXSN-asX, pLXSN-asP, and pLXSN-asXP groups than in other groups (P < 0.05). No significant abnormality was found in the tissues in all groups. CONCLUSION: Dual-target antisense RNA targeting the X and P regions in the genome of HBV inhibits the replication and expression of HBV, significantly stronger than single-target antisense-RNA.