Safety and efficacy of endoscopic ultrasound-guided gastroenterostomy for gastric outlet obstruction in different sites: A single-center retrospective study.

OBJECTIVES: Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) has recently been employed as a novel treatment for gastric outlet obstruction (GOO). The aim of this study was to evaluate the safety and efficacy of EUS-GE for GOO at different sites. METHODS: Consecutive hospitalized patients who underwent EUS-GE for GOO at the Department of Gastroenterology, Nanjing Drum Tower Hospital from March 2017 to April 2020 were recruited in this retrospective study. Patients were divided into three groups depending on the obstruction site. The primary outcomes included technical success and clinical success. The secondary outcomes were operation time, post-procedure length of stay (LOS), hospitalization cost, and complications such as peritonitis, bleeding, pneumoperitoneum, abdominal pain, and infection. RESULTS: A total of 51 patients were included. Technical success achieved in 100% patients with proximal GOO and in 88.9% with distal GOO (P = 0.176). Clinical success declined from the oral side to the anal side (P = 0.510). Operation time, hospitalization costs, and post-procedural LOS were similar among groups (P = 0.532, 0.520, and 0.144, respectively). Complications were observed in 28 (54.9%) patients. In approaching the mature phase of the endosopist, clinical success improved, while the secondary outcomes showed no statistically significant difference compared with the initial phase. CONCLUSIONS: EUS-GE may be challenging for distal GOO; however, it is safe and effective when carried out by experienced endoscopists. A complete preoperative evaluation to assess the difficulty of the procedure is necessary. Prospective studies with large sample size are needed to further validate our findings.

Effect of Simiao Yongan Tang on Permeability of Vasa Vasorum of Atherosclerotic Plaque / 中国实验方剂学杂志

Objective:To observe the effect of Simiao Yongan Tang on the pathologic morphology of atherosclerosis (AS) vulnerable plaque and the permeability of vasa vasorum (VV), and to explore its intervention mechanism with VV as the target. Method:Healthy male ApoE-/- mice were randomly divided into model group, Simiao Yongan Tang group(11.7 mg·kg-1·d-1)and simvastatin group(2.6 mg·kg-1·d-1). High-fat diet supplemented with 1.1% L-methionine was given to induce the animal model, while C57BL/6 mice were used as the control group. The model was evaluated after 8 weeks of feeding. After successful modeling, continued drug intervention was given for 8 weeks, and the pathological changes of the mouse aorta were observed by oil red O staining. The expression levels of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) proteins in the outer membrane of aortic root plaques were observed by immunohistochemical staining. Result:The results of oil red O staining showed that as compared with the control group, the plaque area of the aortic wall was significantly increased in the model group (PPPPPPConclusion:Simiao Yongan Tang can reduce the area of mouse aortic plaque, reduce the VV permeability of the outer plaque by regulating the expression of MMP-9 and TIMP-1, and stabilize the vulnerable plaque.

Preparation of a silver nanoparticle-based dual-functional sensor using a complexation-reduction method.

A dual-functional sensor based on silver nanoparticles was synthesized by a two-stage procedure consisting of a low-temperature chitosan-Ag(+) complexation followed by a high-temperature reduction of the complex to form chitosan-capped silver nanoparticles (CS-capped Ag NPs). The surface plasmon resonance (SPR) absorption and fluorescence emission of the silver nanoparticles were influenced by the concentration and degradation time of chitosan, and the temperatures of the complexation and reduction reactions. The SPR absorption band was blue-shifted while the intensities of emission and absorption were decreased after reacting the silver nanoparticles with Hg(2+) ions. The silver nanoparticles reacted with Hg(2+) were characterized by high resolution transmission electron microscopy (HRTEM), energy dispersive spectroscopy (EDS), X-ray photoelectron spectroscopy (XPS), and surface-enhanced Raman scattering spectroscopy (SERS). The results suggested that the particle growth and aggregation of the silver nanoparticles were caused by the adsorption of Hg(2+) and deposition of Hg(0) on the nanoparticle surface. Direct correlations of the SPR absorption and fluorescence emission with the concentration of Hg(2+) were useful for quantitative analysis of Hg(2+). It was possible to use the dual-functional silver nanoparticles as a colorimetric and fluorescent sensor for sensitive and selective detection of Hg(2+) ions.

Efficacy analysis of methylprednisolone plus adrenaline to treat wasp sting injury.

OBJECTIVE: To observe the effect of methylprednisolone (MP) plus adrenaline to treat patients injured by wasp stings. METHODS: This study was carried out at The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei Province, China, from June to November 2008. A total of 45 cases were divided into 2 groups. The MP was used alone in the control group, and MP plus adrenaline was used in the observation group. We compared the clinical effect between the 2 groups. RESULTS: The alanine aminotransferase (ALT) (64.05 +/- 59.31 versus 124.14 +/- 80.01 U/L), and creatine kinase isoenzyme (CKMB) (90.32 +/- 85.19 versus 216.68 +/- 277.58 umol/L) levels of the observation group were significantly lower than those of the control group. The length of hospital stay of the observation group was significantly shorter than that of the control group (7.23 +/- 2.93 versus 11.23 +/- 8.02), while complications from the wasp sting were fewer than those of the control group. In addition, the level of peripheral blood leukocytes was positively correlated with the number of stings (r=0.733, p=0.001), levels of ALT and CKMB (r=0.627, p=0.001, and r=0.705, p=0.001), and length of hospital stay (r=0.667, p=0.001). CONCLUSION: Allergic and inflammatory responses play an important role in addition to the direct effect of wasp venom on the human body. Compared with MP alone, early combination of adrenaline helps to further inhibit the diffusion of allergy and inflammatory cytokines, and therefore reduce the severity of injury.