Novel endoscopic tangential sawing technique in treatment of giant gastric bezoars: a retrospective single-center study (with video).

BACKGROUND AND AIMS: The current methods for treatment of giant gastric bezoars mainly include chemical dissolution, endoscopic fragmentation, and surgical removal, which often have limited curative effects or generate multiple adverse events. Therefore, there is an urgent need to find new methods to overcome such a dilemma. The aim of this study was to evaluate the safety, efficacy, and feasibility of a novel guidewire-based tangential sawing fragmentation (GTSF) technique to treat giant gastric bezoars. METHODS: This retrospective single-center study was performed in the Department of Gastroenterology and Hepatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital. Ten patients with giant bezoars were consecutively enrolled from December 8, 2019 to April 8, 2021. We treated the 10 patients with the GTSF technique, recorded the GTSF procedure, and followed the patients with gastroscopy 2 weeks after the procedure. RESULTS: All patients were successfully treated by the GTSF technique, and the giant bezoar was broken into small pieces (<2 cm in diameter). The average operation time was 21.73 minutes, and the average fragmentation time was 8.06 minutes. Ten patients treated with the GTSF technique attained satisfactory treatment results, with no acute adverse events or alimentary canal injury during the procedure, and no bezoar residue remained as shown by gastroscopy 2 weeks after the procedure. CONCLUSIONS: The GTSF technique is a safe, effective, and feasible method for removing giant bezoars and can be considered as an alternative treatment of this disease.

Comparison of the clinical value of multi-band mucosectomy versus endoscopic mucosal resection for the treatment of patients with early-stage esophageal cancer.

The present study aimed to compare the clinical value of multi-band mucosectomy (MBM) versus endoscopic mucosal resection (EMR) for the treatment of patients with early-stage esophageal cancer. Between January 2011 and December 2012, 68 patients with early-stage esophageal cancer who underwent MBM and EMR were enrolled into the present study. The curative resection rate, duration of surgery, complications and follow-up records were retrospectively analyzed. Of the 68 patients included, 33 were treated with MBM and 35 with EMR. There was no significant difference in the rate of complete resection between the MBM and EMR groups (P>0.05). The mean duration of surgery in the MBM group was statistically lower than that in the EMR group (P<0.05). There was no statistically significant difference in the intraoperative and post-operative complications between the MBM and EMR groups (P>0.05). Esophageal cancer reoccurred in 2 patients treated with MBM and 1 patient treated with EMR during the follow-up period (range, 3-24 months). Overall, MBM can be considered a better surgical option for the management of patients with early-stage esophageal cancer, as it offers higher histological curative resection rates and improved safety. However, further studies and a larger follow-up period are required to confirm the long-term curative effect.

[Plant N status in the alpine grassland of the Qinghai-Tibet Plateau: base on the N: P stoichiometry].

Plants from different functional groups show distinct response to nitrogen (N) addition, however, the patterns and underlying mechanisms across the natural N availability gradient remain unexplored. In present studies, effects of soil N fertility on aboveground N pools and production were examined, and the N: P stoichiometry was compared among forbs, graminoids, and legumes on an alpine grassland located in northeast of Qinghai-Tibet Plateau. Mean N: P ratios of the whole community in 2008 and 2009 were 9. 83 and 11.57, respectively, indicating that the sub-alpine grassland was mainly N-limited. The partial redundancy analysis (partial RDA) showed that the biomass percentage of forbs increased, while those of legumes and graminoids decreased with the soil N availability. It suggested that legumes and graminoids were more competitive than forbs in the natural N-limited grassland, which may be due to the N2-fixation ability and high nutrient use efficiency, respectively. Under the projected increasing N deposition, the vegetation tended to shift from graminoids and legumes to forbs. Significant relationships were found between the percentage of legumes biomass and N: P (phosphorus) ratio for the whole community and non-legumes, indicating that legumes could improve the community N status as well as non-legumes N status on the alpine grassland.

[Morphological differentiations of the gills of two Gymnocypris przewa-lskii subspecies in different habitats and their functional adaptations].

Gill morphologies of two subspecies of Gymnocypris przewalskii (Gymnocypris przewalskii przewalskii and Gymnocypris przewalskii ganzihonensis) in different habitats were analyzed under scanning electron microscope. Results indicated that G. p. przewalskii had numerous long and dense-lined gill rakers while G. p. ganzihonensis had few short and scatter-lined gill rakers. There were no significant differences in distance between gill filaments (DBF) and distance gill lamella (DBL) between the two subspecies, but gill filaments of G. p. przewalskii were longer than in G. p. ganzihonensis. The electron microscopic study indicated that the pavement epithelium cells of G. p. przewalskii were well defined as irregular ovals, but were hexagonal in G. p. ganzihonensis. Moreover, G. p. przewalskii had more chloride cells than G. p. ganzihonensis, and mucous cells were only found on the surface of gill filaments of G. p. przewalskii. The morphological differences between the two subspecies of G. przewalskii are adaptations to their corresponding diets and habitats.

[Effects of nonylphenol exposure via placenta on early nervous reflex and locomotives of offspring in rat].

OBJECTIVE: To explore the influence of nonylphenol (NP) on the neural behavioral development of filial generation rats exposed via placenta. METHODS: On the first day of the pregnancy, the SD rats were divided into four groups, and orally administered with NP at doses of 0, 50, 100 and 200 mg/kg on gestational day 9 approximately 15 respectively. The offspring rats of each groups were examined to observe the impact of NP on the early physiological, neurobehavioral development. The changes of filial generation body weight (from generation day 1 to 28) were measured. Brain tissues were stained with Hematoxylin-eosin and Congo red to observe with optical microscope. RESULTS: In contrast to the control group, the early physiological markers (pinna detachment, hair growth, tooth growth and eye opening) and the early neurobehavioral development indices (surface righting, air righting, acoustic startle and visual placing) were significantly delayed in the groups of NP 200mg/kg dose (P < 0.05). The developing time of physiological markers decreased from (4.5 +/- 0.8, 5.2 +/- 0.8, 12.7 +/- 1.4, 16.0 +/- 1.7) d to (3.6 +/- 0.5, 3.6 +/- 0.5, 11.1 +/- 1.1, 12.7 +/- 1.3) d while neurobehavioral developing time decreased from (6.5 +/- 0.8, 11.3 +/- 0.5, 11.2 +/- 1.0, 20.2 +/- 1.0) d to (5.1 +/- 0.4, 8.3 +/- 0.5, 9.3 +/- 0.5, 9.3 +/- 0.5) d (P < 0.05 or P < 0.01). The body weights of filial generation rats were decreased obviously from 1 st day to 28th day. Histopathological examination displayed that hippocampal neurons had congestion and oedema in the group of 100, 200 mg/kg dose. CONCLUSION: Exposures to NP during gestation might impair the neurobehavioral development of F1 rats significantly.

[Clinical observation on treatment of cerebral infarction by combined therapy of acupuncture with extremities tissue separating manipulation].

OBJECTIVE: To observe the curative effect of combined treatment of extremities tissue separating manipulation (ETSM) and acupuncture on cerebral infarction (CI). METHODS: CI patients were randomly divided into 3 groups. Group A was treated with drug-therapy only, Group B was treated with drug-therapy plus acupuncture and Group C was treated with drug-therapy plus ETSM and acupuncture. All patients were treated for 15 successive days for evaluating curative effect. RESULTS: The cured-markedly effective rate, total effective rate and nerve function deficit score after treatment was 28.6% , 71.4% and 17.57 +/- 1.51 scores in Group A, 48.4%, 80.6% and 13.97 +/- 1.38 scores in Group B, and 81.3%, 93.7% and 11.00 +/- 1.51 scores in Group C, respectively. Significant difference was shown in comparison of Group A with Group B, also in comparison of Group C with Group A and B (All P <0.05). CONCLUSION: ETSM combined acupuncture has a good therapeutic effect on CI.