Analysis of the detection rate and clinical characteristics of early gastric cancer by painless gastroscopy and ordinary gastroscopy.

OBJECTIVE: To investigate the difference of early gastric cancer (EGC) detection rate and endoscopic characteristics between painless and ordinary electronic gastroscopy, and summarize the clinical data of gastric cancer (GC) patients. METHODS: Clinical data of 72,000 patients who underwent gastroscopy in the First People Hospital of Huzhou (Zhejiang, China) from January 2016 to December 2021 were retrospectively analyzed. The patients were divided into painless gastroscopy group (observation group, 36,000 cases) and ordinary gastroscopy group (control group, 36,000 cases) according to the examination methods. The detection rate of EGC between the 2 groups and the endoscopic characteristics of EGC lesions between the 2 groups were compared, and the clinical data of GC were summarized. RESULTS: Painless gastroscopy is safer than ordinary gastroscopy. The detection rate of GC and EGC in the observation group was significantly higher than that in the control group (P < .05); the difference between the 2 groups in the detection rate of advanced GC was not statistically significant. The average length of EGC lesions in the observation group was significantly shorter than that in the control group (P < .05). The proportion of EGC with lesion length <2.0 cm in the observation group was significantly higher than that in the control group (P < .05). The proportion of EGC lesions with type II morphology, normal or pallor mucosal color, and no rupture in mucosa in the control group were significantly lower than that in the observation group, respectively (P < .05). The proportion of EGC distributed in the cardia, fundus and corpus was higher in the observation group than in the control group (P < .05). The incidence of helicobacter pylori (HP) infection, precancerous diseases, first-degree relatives of GC patients, and risk factors in patients with GC was significantly higher than that in non-GC patients (P < .05), multivariate logistic regression analysis showed that these were independent influencing factors for the occurrence of GC. CONCLUSION: Painless gastroscopy can effectively improve the screening and diagnostic efficiency of EGC, especially for EGC lesions that are not easy to expose the site, small in size, superficial, without obvious mucosal color change or without mucosal breakage. Therefore, the value of painless gastroscopy in EGC screening is worth further promotion and research.

Anatomical relationship between the omohyoid muscle and the internal jugular vein on ultrasound guidance.

BACKGROUND: Internal jugular vein catheterization is widely used in clinical practice, and there are many related studies on internal jugular vein catheterization. However, the omohyoid muscle, which is adjacent to the internal jugular vein, is a rarely mentioned muscle of the infrahyoid muscles group. The purpose of this study is to explore the anatomical relationship between the omohyoid muscle and the internal jugular vein on ultrasound guidance and provide a theoretical reference for jugular puncture and catheterization. METHODS: The study included 30 volunteers. The volunteer's head lay in the neutral position and was then turned to the left at an angle of 30°, 45° and 60° with the bed surface, as verified using an adjustable protractor. A high-frequency ultrasound probe (6-14 Hz) was used to examine the plane of the apex of sternocleidomastoid triangle (PAST), the triangle consists of anatomical landmarks: a base was clavicle, its sides - heads of sternocleidomastoid muscle. And the plane of the middle of sternocleidomastoid triangle(PMST) which was a horizontal line, connecting midpoints of both sides. The right omohyoid muscle (OM) and the right internal jugular vein (IJV) were observed and recorded for statistical analysis. RESULTS: There were statistically significant differences in the number of overlapping cases of OM and IJV at each head rotation angle between the PAST and PMST groups. There were statistically significant differences between the angles which OM and IJV centre point line and the left horizontal position of the PAST and PMST at different body angles. CONCLUSION: The traditional middle route puncture point is the apex of the sternocleidomastoid triangle, which can effectively avoid injury to the omohyoid muscle, to an extent. TRAIL REGISTRATION: ChiCTR2000034233 , Registered 29/06/2020. www. Chinese Clinical Trial Registry.gov.

Effects of cisatracurium in combination with ventilation on inflammatory factors and immune variations in sepsis rats.

The effects of cisatracurium in combination with ventilation on inflammatory factors and immune variations in sepsis rats were investigated. A total of 54 male Sprague-Dawley rats were selected and divided randomly into three groups: Sham group (n=6), model group (n=24) and experiment group (n=24). Rats in the model and experiment groups underwent cecal ligation and puncture (CLP) for establishment of sepsis model. Rats in experiment group additionally received cisatracurium medication in combination with ventilation for treatment. At 6, 12 and 24 h after CLP, the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1ß, IL-6 and procalcitonin (PCT) in serum and the ratio of leukocyte to neutrophil in peripheral blood was also detected. Twenty-four hours later, the expression of high mobility group box 1 (HMGB1) in lung tissues and cluster of differentiation (CD) 4+ and CD8+ in T-lymphocyte subsets were also detected, and the wet/dry (W/D) ratio of lung was measured. Compared with that in model group, the levels of inflammatory factors in the experiment group were significantly decreased, while the indicators in assays of cellular immunity were obviously elevated. Ratio of leukocyte to neutrophil in peripheral blood was significantly decreased after treatment. Cisatracurium in combination with ventilation can alleviate the inflammatory injury to organs in sepsis rats through inhibiting the inflammatory responses and regulating the immune functions, which manifests a new significance in guiding the clinical diagnosis and treatment.