Comparison of endoscopic submucosal dissection and surgery for the treatment of gastric submucosal tumors originating from the muscularis propria layer: a single-center study (with video).

INTRODUCTION: Endoscopic submucosal dissection (ESD) has been used for the treatment of gastric submucosal tumors (SMTs). This study aims to compare clinical outcomes of ESD versus laparoscopic wedge resection (LWR) for gastric SMTs. METHODS: This is a retrospective cohort study. Patients with SMTs who underwent ESD or LWR were enrolled in this study at a university-affiliated hospital from January 2010 to October 2015. Preoperative endoscopic ultrasound and computed tomography were performed to determine origin of layer and growth pattern. Clinical outcomes including baseline demographics, tumor size, operation time, blood loss, hospital stay, cost, pathology and postoperative complications were compared. RESULTS: From January 2010 to October 2015, 68 patients with SMTs received ESD and 47 patients with SMTs received LWR. There was no difference in age, gender, body mass index, origin of layer and proportion with symptoms between ESD group and LWR group. However, tumor size was significantly larger in the LWR group (37.1 mm) than in the ESD group (25.8 mm, P = 0.041). For patients with tumors smaller than 20 mm, ESD was associated with shorter mean operation time (89.7 ± 23.5 vs 117.6 ± 23.7 min, P = 0.043), less blood loss (4.9 ± 1.7 vs 72.3 ± 23.3 ml, P < 0.001), shorter length of hospital stay (3.6 ± 1.9 vs 6.9 ± 3.7 days, P = 0.024) and lower cost (2471 ± 573 vs 4498 ± 1257 dollars, P = 0.031) when compared with LWR. For patients with tumors between 20 mm and 50 mm, ESD was associated with shorter mean operation time (99.3 ± 27.8 vs 125.2 ± 31.5 min, P = 0.039), less blood loss (10.1 ± 5.3 vs 87.6 ± 31.3 ml, P < 0.001), shorter length of hospital stay (4.0 ± 1.7 vs 7.3 ± 4.5 days, P = 0.027) and lower cost (2783 ± 601 vs 4798 ± 1343 dollars, P = 0.033) when compared with LWR. There were no significant differences in terms of rates of en bloc resection, complete resection and complication and histological diagnosis regardless of tumor size. CONCLUSIONS: ESD can achieve similar oncological outcomes when compared with surgery for treatment of gastric SMT smaller than 50 mm.

Comparison of endoscopic resection and gastrectomy for the treatment of early gastric cancer: a meta-analysis.

BACKGROUND: Endoscopic resection methods, including endoscopic mucosal resection and endoscopic submucosal dissection, have become standard treatment modalities for patients with early gastric cancer (EGC) and absolute indications, with en bloc resection being more frequent with the latter. Endoscopic resection, however, has been associated with higher recurrence and metachronous cancer rates than gastrectomy. This meta-analysis compared the efficacy and safety of endoscopic resection and gastrectomy for EGC. METHODS: PubMed, EMBASE and Web of Science were electronically searched for relevant studies comparing endoscopic resection and gastrectomy for EGC from 1976 through March 2015. The primary endpoints were en bloc resection and histologically complete resection rates. The secondary endpoints were duration of hospital stay and rates of complications, recurrence, metachronous cancer and overall survival. RESULTS: This meta-analysis enrolled 10 studies with 2070 patients: 993 patients who underwent endoscopic resection and 1077 who underwent gastrectomy. Endoscopic resection was associated with shorter hospital stay (standardized mean difference -2.02; 95 % confidence interval [CI] -2.64 to -1.39) and lower complication rate (relative risk [RR] 0.41; 95 % CI 0.22-0.76) than gastrectomy. However, endoscopic resection was associated with lower rates of en bloc resection (odds ratio [OR] 0.05; 95 % CI 0.02-0.16) and histologically complete resection (OR 0.04; 95 % CI 0.01-0.11) and higher rates of recurrence (RR 5.23; 95 % CI 2.43-11.27) and metachronous cancer (RR 5.22; 95 % CI 2.40-11.34) than gastrectomy. Overall survival rate (OR 1.18; 95 % CI 0.76-1.82) was similar. CONCLUSIONS: Endoscopic resection is minimally invasive and as effective as surgery, suggesting that the former be considered standard treatment for EGC. It should be recommended as standard treatment for EGC with indications. Additional randomized controlled trials from more countries are required.

[Time-Resolved XEOL Experiment System on BL14W1 at SSRF].

A novel time-resolved X-ray excited optical luminescence (TRXEOL) experiment system was developed for X ray absorption fine structure spectroscopy(XAFS) beamline at Shanghai Synchrotron Radiation Facility (SSRF). The TRXEOL system is composed of three parts: timing system, spectrometer system and nuclear instrument module (NIM) system. These three systems were integrated to measure and record the optical luminescence from the sample excited by the synchrotron X-ray pulses, according to the time-correlated single photon counting methodology. It's the first time in the domestic synchrotron radiation facilities to achieve TRXEOL experiment using the synchrotron X-ray pulses and the time structure of the storage ring. In this work, a SSRF-self-developed timing system was used, which is based on the Field programmable Gate Array and the high-speed serial communication technology. The timing system can provide trigger pulse synchronized with the X-ray pulse. The timing jitter is about 6 ps, and the timing delay resolution is 5 ps. The NIM system is the core of the TRXEOL experiment system, it has three main modules: the Constant Fraction Discriminator (CFD), the Time to Amplitude Converter (TAC) and the Multi-Channel Analyzer (MCA). During one excitation circle, the spectrometer and the Photomultiplier Tube detector translate the induced luminescence of the sample excited by a single X-ray pulse into electrical pulse. The CFD module eliminates the timing walk larger than 50 ps induced by the amplitude of the electrical pulse. The TAC module calculates the time interval between the timing trigger pulse and the luminescence electrical pulse, and converts the interval into proportional amplitude of voltage. After plenty of circles, the MCA module gets the luminescence decay curve by recording and analyzing the voltage signals. And the data acquisition system gets the TRXEOL spectra by scanning the spectrometer and acquiring the frequency of the voltage pulses from the TAC module. The TRXEOL experiment system helps researchers measure optical decay curves and spectra of the sample in different time windows. Many luminescence behaviors would be explained more deeply, together with the aid of the optical XAFS to get the electron structure of the sample. A sample of ZnO nanowire was studied using the TRXEOL system. The ordinary XEOL spectrum obtained could distinguish the 390 nm wavelength and the 500 nm wavelength luminescence center. The decay curve at 0 nm wavelength could clearly show the fast luminescence process and the slow luminescence process. The full width at half maximum of the fast luminescence decay curve was about 0.5 ns, showing that the minimum time resolution of the TRXEOL system is less than 1 ns. The TRXEOL spectra obtained could respectively get the luminescence information within different time windows. It was demo nstrated that the TRXEOL system is not only feasible and reliable, but also supply XAFS beamline with the technical preparatio ns of time resolved techniques.

Therapeutic role of endoscopic ultrasound in pancreaticobiliary disease: A comprehensive review.

With the development of technology and accessories, the role of endoscopic ultrasound (EUS) has evolved from diagnostics to therapeutics. In order to characterise the therapeutic role of EUS, we searched Web of Knowledge database and reviewed articles associated with therapeutic EUS. There are two modalities for the therapeutic purpose: drainage and fine-needle injection. EUS-guided drainage is a promising procedure for the treatment of peripancreatic fluid collection and biliary obstruction; EUS-guided fine-needle injections such as celiac plexus neurolysis, for the purpose of pain relief for pancreatic cancer and chronic pancreatitis, has emerged as a promising procedure. The aim of the study was to perform a comprehensive and conscientious review on the techniques, complications and clinical outcomes of those EUS-based procedures.

New endoscopic ultrasound techniques for digestive tract diseases: A comprehensive review.

Endoscopic ultrasound (EUS) is one of the most important modalities for the diagnosis of digestive tract diseases. EUS has been evolving ever since it was introduced. New techniques such as elastography and contrast enhancement have emerged, increasing the accuracy, sensitivity and specificity of EUS for the diagnosis of digestive tract diseases including pancreatic masses and lymphadenopathy. EUS-elastography evaluates tissue elasticity and therefore, can be used to differentiate various lesions. Contrast-enhanced EUS can distinguish benign from malignant pancreatic lesions and lymphadenopathy using the intravenous injection of contrast agents. This review discusses the principles and types of these new techniques, as well as their clinical applications and limitations.

[Effects of applying sewage sludge on chemical form distribution and bioavailability of heavy metals in soil].

A pot experiment was conducted to study the effects of applying sewage sludge on the chemical form distribution of heavy metals (Cd, Pb, Cu and Zn) in soil and the transfer and accumulation of the heavy metals in soil-plant (ryegrass) system. With the application of sewage sludge, the contents of bioavailable Cd and Zn in soil increased significantly but that of bioavailable Pb in soil had a significant decrease, and the content of residual form Pb in soil increased by 33.3% -74.5%, compared with CK. When the application rate of sewage sludge was 50% (M/M) of soil, the contents of exchangeable and reducible Cu in soil only occupied 0.7% and 0.2% of the total Cu respectively. The application of sewage sludge promoted the Cd, Cu and Zn absorption while inhibited the Pb absorption by ryegrass. Multiple linear regression analysis showed that the Cd, Zn and Cu contents in ryegrass were positively correlated with the reducible Cd and Zn and oxidizable Cu contents in soil, respectively, and Pb content in ryegrass was highly correlated with the soil exchangeable and oxidizable Pb contents. After planting ryegrass, the oxidizable Cd and Cu in rhizosphere soil were transformed into exchangeable Cd and residual form Cu, respectively, the exchangeable and reducible Zn transformed into oxidizable Zn, whereas the bioavailability of Pb was less affected.

[Investigation on damage of bovine serum albumin (BSA) catalyzed by nano-sized silicon dioxide (SiO2) under ultrasonic irradiation using spectral methods].

The damage of bovine serum albumin (BSA) molecules under ultrasonic irradiation in the presence of nano-sized silicon dioxide (SiO2) particles was studied by UV-Vis and fluorescence spectra. In addition, the influences of ultrasonic irradiation time, nano-sized SiO2 addition amount, solution acidity (pH) and ultrasonic irradiation power on the damage of BSA molecules in aqueous solution were also detected. For BSA solution of 1.0 x 10(-5) mol x L(-1) at (37.0+/-0.2) degrees C, the UV-Vis spectra of BSA solutions showed that the absorption peaks of BSA displayed obvious hyperchromic effect with the increase in some influence factors such as ultrasonic irradiation time, nano-sized SiO2 addition amount, pH value and ultrasonic irradiation power. However, the fluorescence spectra of BSA solutions showed the phenomenon of fluorescence quenching with the increase in ultrasonic irradiation time, nano-sized SiO2 addition amount, pH value and ultrasonic irradiation power. Moreover, the possible mechanism behind the damage of BSA molecule in the presence of nano-sized SiO2 powders under ultrasonic irradiation was discussed. It was considered that the damage of BSA molecules was attributed to the formation of *OH radicals resulting from the sonoluminescence and high-heat excitation of ultrasonic cavitation. The research results could be of great significance to using sonocatalytic method to treat tumour in clinic application and for developing nano-sized drug in the future.

[Interaction of tributyltin (TBT) compound and bovine serum albumin (BSA)].

Tributyltin (TBT) compound is one of the main components of antifouling paint for boats and ships. The interaction of TBT compound and bovine serum albumin (BSA) was investigated by ultraviolet, fluorescence and circular dichroism (CD) spectra. The influences of concentration, acidity and organic solvent were also studied. The results showed that the interaction of TBT and BSA was dual, showing not only the hydrophobic actions of butyl groups but also the coordination action of tin cation with BSA molecule, which resulted in the exposures of aromatic amino acids residues of tryptophane and tyrosine in BSA molecule, the destruction of BSA secondary structure, the decrease in alpha-helix content, and the transformation of the conformation.

[Sonocatalytic degradation of ethyl violet in the presence of high dispersion TiO2 and the comparison of catalytic activity with suspension TiO2].

Ethyl violet was chose as a model compound in this paper. The ultrasound of 50 W power and 40 kHz frequency was used as an irradiation source to induce TiO2 particles. We have compared sonocatalytic degradation ratios in the presence of dispersion TiO2 and suspension TiO2 sonocatalysts. It was found that the degradation effect in the presence of dispersion TiO2 was much higher than that in the presence of suspension TiO2. The degradation ratios of ethyl violet in the presence of dispersion TiO2 attains 78.45%, while the degradation ratios of ethyl violet in the presence of suspension TiO2 with onefold ultrasonic irradiation are only 27.12% and 10%, respectively. In addition, a variety of affecting factors including irradiation time of ultrasound, adding amount of TiO2 catalyst, initial concentration of ethyl violet, ultrasonic power and temperature on sonocatalytic degradation of ethyl violet were also reviewed, as well as the possible degradation mechanism was also discussed. The experimental results indicate that the sonocatalytic degradation method in the presence of dispersion TiO2 catalyst is an advisable choice for the treatments of non- or low-transparent organic wastewaters in future.

[Preparation of nanometer TiO2 doped with upconversion luminescence agent and investigation on degradation of ethyl violet using visible light].

A novel upconversion luminescence agent 40CdF2 x 60BaF2 x 1.6Er2O3 was synthesized and the fluorescent spectrum was determined. This upconversion luminescence agent can emit five upconversion fluorescent peaks whose wavelengths are all below 387nm under the excitation of 488 nm visible light. This upconversion luminescence agent was mixed into nanometer TiO2 powder by ultrasonic dispersion and the doped nanometer TiO2 photocatalyst utilizing visible light was prepared. The doped TiO2 powder was charactered by XRD and TEM and its photocatalytic activity was checked through the photocatalytic degradation of ethyl violet dye as a model compound under the visible light irradiation emitted by three basic color lamp. Otherwise, in order to compare the photocatalytic activities the same experiment was carried out for undoped photocatalytic TiO2 powder. The degradation ratio of ethyl violet dye in the presence of doped nanometer TiO2 powder reached 99.68% under visible light irradiation at 12.0 h which was obviously higher than the corresponding degradation ratio in the presence of undoped nanometer TiO2 powder, which indicate that the upconversion luminescence agent prepared as dopant can effectively turn visible lights to ultraviolet lights which are absorbed by nanometer TiO2 particles and produce the electron-cavity pairs.

Degradation of dyestuff wastewater using visible light in the presence of a novel nano TiO2 catalyst doped with upconversion luminescence agent.

A new upconversion luminescence agent, 40CdF2 x 60BaF2 x 0.8Er2O3, was synthesized and its fluorescent spectra were determined. This upconversion luminescence agent can emit five upconversion fluorescent peaks shown in the fluorescent spectra whose wavelengths are all below 387 nm under the excitation of 488 nm visible light. This upconversion luminescence agent was mixed into nano rutile TiO2 powder by ultrasonic and boiling dispersion and the novel doped nano TiO2 photocatalyst utilizing visible light was firstly prepared. The doped TiO2 powder was charactered by XRD and TEM and its photocatalytic activity was tested through the photocatalytic degradation of methyl orange as a model compound under the visible light irradiation emitted by six three basic color lamps. In order to compare the photocatalytic activities, the same experiment was carried out for undoped TiO2 powder. The degradation ratio of methyl orange in the presence of doped nano TiO2 powder reached 32.5% under visible light irradiation at 20 h which was obviously higher than the corresponding 1.64% in the presence of undoped nano TiO2 powder, which indicate the upconversion luminescence agent prepared as dopant can effectively turn visible lights to ultraviolet lights that are absorbed by nano TiO2 particles to produce the electron-cavity pairs. All the results show that the nano rutile TiO2 powder doped with upconversion luminescence agent is a promising photocatalyst using sunlight for treating the industry dye wastewater in great force.

Sonocatalytic degradation of methyl orange in the presence of (nanometer and ordinary) anatase TiO2 powders.

The nanometer and ordinary anatase titanium dioxide (TiO2) powders were adopted as the sonocatalysts for the degradation of methyl orange used as a model compound for the first time. It was found that the sonocatalytic degradation effect of methyl orange in the presence of TiO2 powder were much better than that without TiO2, but the sonocatalytic activity of the nanometer anatase TiO2 particle was obviously higher than that of ordinary anatase TiO2 particle. Although there are many factors influencing sonocatalytic degradation of methyl orange, the experimental results showed that the best degradation ratio of methyl orange could be obtained when the experimental conditions were: initial concentration 15 mg/L, nanometer anatase TiO2 adding amount 750 mg/L, ultrasonic frequency 40 kHz, output power 50 W, pH = 3.0 and temperature 40 degrees C within 150 min. In addition, the catalytic activity of reused nanometer anatase TiO2 catalyst was also studied and found to decline gradually comparing with initial nanometer anatase TiO2 catalyst. All experiments indicated that the method of the sonocatalytic degradation of organic pollutants in the presence of TiO2 powder was an advisable choice for non- or low-transparent organic wastewaters.