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1.
Ther Clin Risk Manag ; 17: 1153-1161, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34764651

RESUMO

Objective: The present study aimed to analyze the risk factors and clinical outcomes of the incomplete endoscopic resection of rectal neuroendocrine tumors (rNETs). Methods: This study retrospectively analyzed the cases of 428 patients with rNETs who had undergone endoscopic treatment in the Department of Gastroenterology at the PLA General Hospital, China, between January 2010 and September 2019. Results: Of the 428 patients with rNETs, 266 were men (62.1%) and 162 were women (37.9%). Of these, 54 had been pathologically diagnosed with positive incisal margins without lymphatic vessel invasion, and the incomplete resection (R1) rate was 12.6%. Among the R1 patients, 28 had received endoscopic submucosal dissection, 22 had received endoscopic mucosal resection, two had received snare resection, and two had undergone removal with forceps. In addition, there were 31 cases of grade G1 R1 resection (11.2%; 31/277), 13 cases of grade G2 R1 resection (23.2%; 13/56), and 10 cases whose grading was not described. The univariate analysis showed the pathological grade was statistically correlated with R1 resection (P < 0.05), and the grade G2 R1 resection rate was higher than that of grade G1. The multivariate logistic regression analysis showed that grade G2 was an independent risk factor leading to R1 resection (P = 0.02). All patients with R1 resection were followed up for 10-110 months, with an average of 38 months. No salvage treatment was performed. The endoscopic monitoring showed there were no recurrences during the follow-up period. Conclusion: Endoscopic resection is a good option for rNETs, with a high complete resection rate and good prognosis, with rare recurrence even if endoscopic resection is not complete.

2.
World J Gastrointest Oncol ; 13(10): 1466-1474, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34721778

RESUMO

Ampullary adenomatous lesions of the gastrointestinal tract are rare and can be asymptomatic. Therefore, ampullary adenomas with malignant potential require prompt removal, regardless of whether they are adenomatous or carcinomatous lesions. Endoscopic papillectomy is a safe and effective alternative therapy to surgery to treat duodenal papillary lesions in selected patients. Accurate preoperative diagnosis and staging of ampullary adenomatous lesions are critical for predicting prognosis and determining the most appropriate therapeutic approach. Furthermore, the management and prevention of adverse events and endoscopic treatment for remnant or recurrent lesions and surveillance are essential for successful endoscopic management of ampullary adenomatous lesions. This literature review was based on PubMed and MEDLINE and focused on recent advancements in the endoscopic papillectomy technique to provide a comprehensive view of endoscopic papillectomy to treat ampullary adenomatous lesions.

3.
ACS Synth Biol ; 10(11): 2796-2807, 2021 11 19.
Artigo em Inglês | MEDLINE | ID: mdl-34738786

RESUMO

Chromosomal integration of exogenous genes is preferred for industrially related fermentation, as plasmid-mediated fermentation leads to extra metabolic burden and genetic instability. Moreover, with the development and advancement of genome engineering and gene editing technologies, inserting genes into chromosomes has become more convenient; integration expression is extensively utilized in microorganisms for industrial bioproduction and expected to become the trend of recombinant protein expression. However, in actual research and application, it is important to enhance the expression of heterologous genes at the host genome level. Herein, we summarized the basic principles and characteristics of genomic integration; furthermore, we highlighted strategies to improve the expression of chromosomal integration of genes and pathways in host strains from three aspects, including chassis cell optimization, regulation of expression elements in gene expression cassettes, optimization of gene dose level and integration sites on chromosomes. Moreover, we reviewed and summarized the relevant studies on the application of integrated expression in the exploration of gene function and the various types of industrial microorganism production. Consequently, this review would serve as a reference for the better application of integrated expression.

4.
Mil Med Res ; 8(1): 20, 2021 03 12.
Artigo em Inglês | MEDLINE | ID: mdl-33712087

RESUMO

Battlefield internal medicine aims at the treatment of combatants and noncombatants with various internal diseases on the battlefield. The military medical research on battlefield internal diseases focuses on the pathogenesis, clinical management, and prevention of internal diseases under military war conditions. In both wartime and peacetime, the soldiers suffer from more internal diseases than surgical wounds. With the introduction of high-tech weapons, including chemical, physical, and biological agents, a large number of special internal illnesses and casualties will appear in future wars. The battles often occur in special environments, such as high or low temperatures, plateau or polar areas, and micro- or hyper-gravity. The current theories of battlefield internal medicine are mainly derived from wars decades ago and cannot meet the needs of military medical support under the conditions of modern warfare. Therefore, the military medical research on battlefield internal medicine should be based on contemporary military situations, focus on the purpose of treating battlefield internal diseases, and adhere to the actual needs of the troops in peacetime and wartime. We should investigate the pathogenesis of battlefield internal diseases and explore the threats that may arise in future wars to ensure the advancement of battlefield internal medicine. This review highlights new concepts, demands, challenges, and opportunities for the further development of military medical research on battlefield internal medicine.


Assuntos
Medicina Interna/tendências , Pesquisa/tendências , Guerra , Humanos , Medicina Interna/instrumentação , Medicina Militar/instrumentação , Medicina Militar/tendências
5.
Front Cell Infect Microbiol ; 11: 640309, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33777850

RESUMO

To characterize the salivary microbiota in patients at different progressive histological stages of gastric carcinogenesis and identify microbial markers for detecting gastric cancer, two hundred and ninety-three patients were grouped into superficial gastritis (SG; n = 101), atrophic gastritis (AG; n = 93), and gastric cancer (GC; n = 99) according to their histology. 16S rRNA gene sequencing was used to access the salivary microbiota profile. A random forest model was constructed to classify gastric histological types based on the salivary microbiota compositions. A distinct salivary microbiota was observed in patients with GC when comparing with SG and AG, which was featured by an enrichment of putative proinflammatory taxa including Corynebacterium and Streptococcus. Among the significantly decreased oral bacteria in GC patients including Haemophilus, Neisseria, Parvimonas, Peptostreptococcus, Porphyromonas, and Prevotella, Haemophilus, and Neisseria are known to reduce nitrite, which may consequently result in an accumulation of carcinogenic N-nitroso compounds. We found that GC can be distinguished accurately from patients with AG and SG (AUC = 0.91) by the random forest model based on the salivary microbiota profiles, and taxa belonging to unclassified Streptophyta and Streptococcus have potential as diagnostic biomarkers for GC. Remarkable changes in the salivary microbiota functions were also detected across three histological types, and the upregulation in the isoleucine and valine is in line with a higher level of these amino acids in the gastric tumor tissues that reported by other independent studies. Conclusively, bacteria in the oral cavity may contribute gastric cancer and become new diagnostic biomarkers for GC, but further evaluation against independent clinical cohorts is required. The potential mechanisms of salivary microbiota in participating the pathogenesis of GC may include an accumulation of proinflammatory bacteria and a decline in those reducing carcinogenic N-nitroso compounds.


Assuntos
Gastrite , Microbiota , Neoplasias Gástricas , Humanos , RNA Ribossômico 16S
6.
World J Gastroenterol ; 26(37): 5673-5681, 2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33088160

RESUMO

BACKGROUND: The management strategies for recurrent ampullary adenoma after endoscopic papillectomy are still controversial. Patients with the recurrent papillary lesions need to receive repetitive endoscopic interventions due to the limitations of conventional endoscopic techniques. AIM: To assess the feasibility, efficacy, and safety of hybrid endoscopic submucosal dissection (ESD) by duodenoscope for recurrent, laterally spreading papillary lesions. METHODS: We enrolled two patients with recurrent, laterally spreading, duodenal papillary adenomas with no intraductal extension confirmed by follow-up between March 2017 and September 2018. After marking the resection borders of the lesion using a dual knife, a submucosal cushion was created by injecting a mixture of saline solution, methylene blue, and adrenaline. A total circumferential incision and submucosal excision was performed by dual knife combined with insulated-tip diathermic knife, and then the lesion was ligated and resected using an electric snare. Endoscopic hemostasis was applied during the endoscopic procedures. Moreover, the endoscopic retrograde cholangiopancreatography (ERCP) procedures, including selective cannulation and stent implantation of biliary and pancreatic ducts, were performed. Additionally, we performed endoclip closure for mucosal defect after ESD. RESULTS: Hybrid ESD using a duodenoscope and biliary and pancreatic stent placement were performed successfully in two patients. The endoscopic size of recurrent papillary lesions was no more than 2 cm. Generally, the average total procedure time was 95.5 min, and the procedure time of ESD and ERCP was 38.5 min and 15.5 min, respectively. No serious complications occurred during the intraoperative and postoperative periods. The histopathological examination revealed tubulovillous adenoma negative for neoplastic extension at the cut margin in both patients. The duodenoscopic follow-up and histopathology of biopsy specimens at 3 mo after ESD showed no residual or recurrent lesions in ampullary areas in both cases. Both cases have been followed up with no recurrence to June 2020. CONCLUSION: Hybrid ESD by duodenoscope is technically challenging, and may be curative for recurrent, laterally spreading papillary adenomas < 2 cm. It should be performed cautiously in selected patients by experienced endoscopists.


Assuntos
Adenoma , Neoplasias Duodenais , Ressecção Endoscópica de Mucosa , Adenoma/diagnóstico por imagem , Adenoma/cirurgia , Neoplasias Duodenais/diagnóstico por imagem , Neoplasias Duodenais/cirurgia , Duodenoscópios , Ressecção Endoscópica de Mucosa/efeitos adversos , Humanos , Mucosa Intestinal , Resultado do Tratamento
7.
ACS Appl Mater Interfaces ; 12(42): 47482-47489, 2020 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-32985877

RESUMO

Narrowing the capacitance gap between the positive and negative electrodes for the enhancement of the energy densities of battery-supercapacitor hybrid (BSH) devices is urgent and very important. Herein, a new strategy to synchronously improve the positive-negative system and reduce the capacitance discrepancies between two electrodes through the utilization of the same MOF-based precursors ([Ni(ATA)2(H2O)2](H2O)3) has been proposed. Nickel/nitrogen codoped carbon (Ni@NC) materials, serving as positive electrodes, deliver battery-type behavior with the enhancement of capacities, which are even superior to those of pristine carbon-based materials with large surface areas. Meanwhile, HCl-treated Ni@NC materials (named A-Ni@NC) are employed as negative electrodes within the potential window of -1 to 0 V and exhibit higher capacitances than that of the commercial activated carbon. With Ni@NC and A-Ni@NC as positive and negative electrodes in BSH devices, the as-fabricated cells display higher capacities and energy densities, more excellent cycling stability, and far superior capacity retention in comparison with those of Ni@NC//AC cells. These results clearly confirm that our strategy is successful and effective.

8.
Bioprocess Biosyst Eng ; 43(12): 2201-2207, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32661565

RESUMO

To improve nicotinic acid (NA) yield and meet industrial application requirements of sodium alginate-polyvinyl alcohol (SA-PVA) immobilized cells of Pseudomonas putida mut-D3 harboring nitrilase, inorganic materials were added to the SA-PVA immobilized cells to improve mechanical strength and mass transfer performance. The concentrations of inorganic materials were optimized to be 2.0% silica and 0.6% CaCO3. The optimal pH and temperature for SA-PVA immobilized cells and composite immobilized cells were both 8.0 and 45 °C, respectively. The half-lives of composite immobilized cells were 271.48, 150.92, 92.92 and 33.12 h, which were 1.40-, 1.35-, 1.22- and 1.63-fold compared to SA-PVA immobilized cells, respectively. The storage stability of the composite immobilized cells was slightly increased. The composite immobilized cells could convert 14 batches of 3-cyanopyridine with feeding concentration of 250 mM and accumulate 418 g ·L-1 nicotinic acid, while the SA-PVA immobilized cells accumulated 346 g L-1 nicotinic acid.


Assuntos
Alginatos/química , Aminoidrolases/química , Álcool de Polivinil/química , Pseudomonas putida/enzimologia , Biocatálise , Carbonato de Cálcio , Células Imobilizadas , Ácidos Hexurônicos , Hidroliases , Concentração de Íons de Hidrogênio , Compostos Inorgânicos , Microscopia Eletrônica de Transmissão , Niacina/química , Piridinas/química , Dióxido de Silício/química , Temperatura
9.
Prog Mol Biol Transl Sci ; 171: 195-213, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32475522

RESUMO

Many components of the gastric non-Helicobacter pylori microbiota have been identified recently thanks to advances in DNA sequencing techniques. Several lines of evidence support the hypothesis that the gastric microbiome is essential for gastric disorders such as gastric cancer. Microbial interactions impact the pathophysiology of various gastric disorders. This chapter provides an overview of recent findings regarding general gastric microbial community profiling, microbial interactions in the stomach, and microbial characteristics in various gastric disorders.


Assuntos
Bactérias/metabolismo , Fungos/fisiologia , Microbioma Gastrointestinal , Interações Microbianas , Gastropatias/microbiologia , Estômago/microbiologia , Animais , Humanos
10.
Front Microbiol ; 11: 997, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32547510

RESUMO

The changes of gastric microbiome across stages of neoplastic progression remain poorly understood, especially for intraepithelial neoplasia (IN) which has been recognized as a phenotypic bridge between atrophic/intestinal metaplastic lesions and invasive cancer. The gastric microbiota was investigated in 30 healthy controls (HC), 21 non-atrophic chronic gastritis (CG), 27 gastric intestinal metaplasia (IM), 25 IN, and 29 gastric cancer (GC) patients by 16S rRNA gene profiling. The bacterial diversity, and abundances of phyla Armatimonadetes, Chloroflexi, Elusimicrobia, Nitrospirae, Planctomycetes, Verrucomicrobia, and WS3 reduced progressively from CG, through IM, IN to GC. Actinobacteria, Bacteriodes, Firmicutes, Fusobacteria, SR1, and TM7 were enriched in the IN and GC. At the community level, the proportions of Gram-positive and anaerobic bacteria increased in the IN and GC compared to other histological types, whereas the aerobic and facultatively anaerobic bacteria taxa were significantly reduced in GC. Remarkable changes in the gastric microbiota functions were detected after the formation of IN. The reduced nitrite-oxidizing phylum Nitrospirae together with a decreased nitrate/nitrite reductase functions indicated nitrate accumulation during neoplastic progression. We constructed a random forest model, which had a very high accuracy (AUC > 0.95) in predicating the histological types with as low as five gastric bacterial taxa. In summary, the changing patterns of the gastric microbiota composition and function are highly indicative of stages of neoplastic progression.

11.
J Chromatogr A ; 1624: 461234, 2020 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-32540074

RESUMO

Atmospheric amines contribute to the nucleation and initial growth of new particles as well as secondary organic aerosol formation, influencing the radiative balance of the Earth's atmosphere. In this study, we develop an ion chromatography (IC) method for separating and quantifying the nine most abundant amines (methylaminium (MMAH+), dimethylaminium (DMAH+), trimethylaminium (TMAH+), ethylaminium (MEAH+), diethylaminium (DEAH+), propylaminium (MPAH+), butylaminium (MBAH+), ethanolaminium (MEOH+), and triethanolaminium (TEOH+)) from six common inorganic species in atmospheric aerosols. The retention times of the amines were altered by the addition of acetonitrile to the eluent because acetonitrile can reduce the adsorption of hydrophobic amines on the stationary phase. The developed method achieved the successful separation of DEAH+ and TMAH+ from inorganic cations, which often coelute with each other in established IC methods. The interference of K+ on the determination of MEAH+ was eliminated by the complexation of K+ with 18-crown-6, which prolonged the retention time of K+. Finally, 9 target amines and 6 common inorganic cations were separated, with a resolution Rs ≥ 1.2 for DEAH+ and MPAH+ and Rs > 1.5 for other species. The detection limits varied in the range of 0.34-1.48 ng for the 9 amines and 0.19-0.56 ng for the inorganic cations. The developed method was successfully applied for the determination of low molecular weight amines and inorganic cations in PM2.5 collected from an urban site in Shanghai and an isolated coast of Chongming Island. Eight amines were detected in the urban samples, in which MMAH+ and DMAH+ dominated. The average amine concentration in the urban aerosols was 76.3 ± 38.4 ng m-3, which is approximately 4-fold higher than those in the marine samples collected from the coast.


Assuntos
Acetonitrilas/química , Aminas/análise , Atmosfera/química , Cromatografia por Troca Iônica/métodos , Éteres de Coroa/química , Compostos Inorgânicos/análise , Aerossóis/análise , Cátions , China , Limite de Detecção , Padrões de Referência
12.
Small ; 16(30): e2001987, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32583970

RESUMO

Two identical layered metal-organic frameworks (MOFs) (CoFRS and NiFRS) are constructed by using flexible 1,10-bis(1,2,4-triazol-1-yl)decane as pillars and 1,4-benzenedicarboxylic acid as rigid linkers. The single-crystal structure analysis indicates that the as-synthesized MOFs possess fluctuant 2D networks with large interlayer lattices. Serving as active electrode elements in supercapacitors, both MOFs deliver excellent rate capabilities, high capacities, and longstanding endurances. Moreover, the new intermediates in two electrodes before and after long-lifespan cycling are also examined, which cannot be identified as metal hydroxides in the peer reports. After assembled into battery-supercapacitor (BatCap) hybrid devices, the NiFRS//activated carbon (AC) device displays better electrochemical results in terms of gravimetric capacitance and cycling performance than CoFRS//AC devices, and a higher energy-density value of 28.7 Wh kg-1 compared to other peer references with MOFs-based electrodes. Furthermore, the possible factors to support the distinct performances are discussed and analyzed.

13.
Brachytherapy ; 19(1): 97-103, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31564517

RESUMO

PURPOSE: The purpose of the study was to investigate the role of iodine-125 seed implantation, guided by endoscopic ultrasound (EUS) and/or percutanous ultrasound, in patients with unresectable pancreatic carcinoma after relief of obstructive jaundice using endoscopic retrograde cholangiopancreatography (ERCP). METHODS AND MATERIALS: A total of 101 patients with obstructive jaundice due to unresectable pancreatic carcinoma were enrolled between January 2010 and December 2017 in this retrospective study. Of these patients, 50 underwent implantation of iodine-125 seeds under EUS and/or percutaneous ultrasound guidance after receiving a stent via ERCP (treatment group), and 51 received a stent via ERCP without undergoing seed implantation (control group). The clinical data and therapeutic outcomes of these patients were analyzed. RESULTS: Compared with the control group, the treatment group obtained significant relief of abdominal pain at the 1-week, 1-month, and 3-month followup (p < 0.05), with a significantly lower visual analog scale pain score (p < 0.05). The treatment group obtained a longer median survival (8.8 vs. 6.5 months, p = 0.02), longer median duration of stent patency (10.8 ± 1.4 vs. 6.9 ± 0.8 months, p = 0.02), and prolonged average time to gastric outlet obstruction (6.8 ± 1.6 vs. 5.3 ± 1.3 months, p = 0.02). Differences between liver function and appetite for the two groups were not significant (p > 0.05 and p = 0.59, respectively). CONCLUSIONS: Iodine-125 seed implantation after relief of obstructive jaundice via ERCP prolongs survival, biliary stent patency, and time to gastric outlet obstruction and improves patient quality of life by relieving pancreatic pain in patients with unresectable pancreatic carcinoma.


Assuntos
Braquiterapia , Icterícia Obstrutiva/cirurgia , Neoplasias Pancreáticas/radioterapia , Dor Abdominal/etiologia , Idoso , Colangiopancreatografia Retrógrada Endoscópica , Endossonografia , Feminino , Obstrução da Saída Gástrica/etiologia , Humanos , Radioisótopos do Iodo , Icterícia Obstrutiva/etiologia , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/complicações , Qualidade de Vida , Estudos Retrospectivos , Stents , Taxa de Sobrevida
14.
Dalton Trans ; 49(2): 411-417, 2020 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-31833493

RESUMO

Two novel interpenetrated 2-fold Mn-based metal-organic frameworks (MOFs) (SC-7 and SC-8), assembled from the rigid ligand H3TATB (4,4',4''-s-triazine-2,4,6-triyl-tribenzoic acid) and Mn ions with the assistance of the flexible N-donor linker BIB (bis((1H-imidazol-1-yl)methyl)benzene) or TIPA (tris(4-imidazolylphenyl)amine), have been successfully prepared. The as-obtained MOFs show two distinct topological structures with the symbols 44·62 and (52·6)(53·6·73·82·9) due to discrepancies between the flexibilities of the bi-imidazole and tri-imidazole linkers. The electrodes based on the as-prepared bulk Mn-MOFs behave as alkaline batteries in electrochemical cells and deliver high capacities (279 and 172 mA h g-1 at 1 A g-1 for SC-7 and SC-8, respectively). Theoretical mechanism analyses indicate that the surface-controlled (k1v) process can be transformed into a diffusion-dominated (k2v1/2) process when the charging time exceeds 30 seconds in the MOF-based systems. Our research provides a new strategy to construct an increasing number of stable redox sites in MOFs for application to battery-capacitor hybrid devices.

15.
Sci Rep ; 9(1): 12874, 2019 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-31492912

RESUMO

This study aimed to investigate the intestinal microbiota in duodenal ulcer (DU) patients, effects of proton pump inhibitors,clarithromycin and amoxicillin, PCA) for Helicobacter pylori (H. pylori) and Bacillus subtilis and Enterococcus faecium (BSEF) on intestinal microbiota. DU patients were randomly assigned to receive either PCA (group TT) or PCA plus BSEF(group TP). The fecal microbiome was conducted using high throughput 16S rDNA gene and internal transcribed spacer sequencings. The diversity and abundance of intestinal bacteria in the DU were significantly lower than health check control (HC) group. In the TT group, the abundance and diversity of both intestinal bacteria and fungi decreased after PCA treatment, compared with those before treatment, whereas in the TP group no obvious changes were observed. In the TT group at all the time points, both the intestinal bacteria and fungi were different from those in the HC group. However, in the TP group, at 10w the bacterial flora abundance was close to that in the HC group. The results indicate that anti- H. pylori treatment induced significant decrease in the diversity of intestinal microbiota, while the combined therapy supplemented with BSEF could protect and restore the intestinal microbiota.


Assuntos
Amoxicilina/uso terapêutico , Claritromicina/uso terapêutico , Úlcera Duodenal/tratamento farmacológico , Microbioma Gastrointestinal/efeitos dos fármacos , Probióticos/uso terapêutico , Inibidores da Bomba de Prótons/uso terapêutico , Adulto , Antibacterianos/uso terapêutico , Antiulcerosos/uso terapêutico , Bacillus subtilis/fisiologia , Biodiversidade , Quimioterapia Combinada , Úlcera Duodenal/microbiologia , Enterococcus faecium/fisiologia , Feminino , Microbioma Gastrointestinal/fisiologia , Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/microbiologia , Helicobacter pylori/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade
16.
Dig Dis ; 37(2): 116-122, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30282076

RESUMO

AIM: To analyze the epidemiological features of colorectal diverticulum (CRD) in China. METHODS: We retrospectively analyzed CRD patients in 8 tertiary hospitals located in 5 regions of China from 2000 to 2016. The detection rates, number and distribution, demographic information, concomitant disorders, and their associations were investigated. RESULTS: Of 3,446,118 cases, 7,964 (2.3%) were CRD with a mean age of 56 years (11-92 years). The detection rate increased yearly and with increasing age. Males had a higher detection rate than females (3.0 vs. 1.47%, p < 0.01) and 1.8-times higher increase rate. The detection rate increased with age; however, females of > 60 years had a 2.8-times increasing rate than males. CRD occurred most frequently in the right-side colon, followed by rectum. Multiple diverticula were common in males and increased with age, with a 3-times higher increase rate than single lesion. Single-segment CRD occurred more frequently in males than in females (80.1 vs. 76.4%, p < 0.01). Concurred colon polyps were seen in 51.05% cases. CONCLUSION: CRD detection rates increased annually and with age, particularly in senior females in China. Multiple diverticula were common in males and increased with age. CRD was predominant in the right-side colon. Polyps are the most common comorbidity associated with CRD.


Assuntos
Divertículo do Colo/epidemiologia , Reto/patologia , Caracteres Sexuais , Adulto , Fatores Etários , Idoso , China/epidemiologia , Comorbidade , Divertículo do Colo/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
17.
Gastrointest Endosc ; 89(4): 872-877, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30391254

RESUMO

BACKGROUND AND AIMS: Natural orifice transluminal endoscopic surgery (NOTES) has been established in animal models and human studies, but few clinical studies have investigated transvaginal NOTES in the diagnosis of unexplained refractory ascites. We aimed to assess the feasibility, efficacy, and safety of transvaginal NOTES for the diagnosis of unexplained ascites in female patients. METHODS: A prospective study was done involving 3 female patients with unexplained ascites. After general anesthesia and disinfection, a 1.0-cm incision was made in the posterior fornix of the vagina. A gastroscope was inserted into the abdominal cavity through the transvaginal incision and an artificial pneumoperitoneum was created; NOTES peritoneoscopy was performed to scrutinize the pathologic changes. Endoscopic biopsy specimens were obtained for pathologic examination. The transvaginal incision was closed by direct suturing. RESULTS: Transvaginal NOTES for diagnostic peritoneoscopy was successfully performed in 3 patients. The mean operative time was 61 minutes. The estimated blood loss was 5 to 10 mL. The pathologic diagnoses were tuberculosis for all patients, and the symptoms and ascites disappeared after antituberculosis therapy. During the 4-year follow-up, no clinically significant adverse events occurred in any patient after NOTES. No patient experienced an annex inflammation, vaginitis, dyspareunia, or sexual dysfunction. All patients were comfortable and satisfied with the nonscarring surgical procedure. CONCLUSIONS: Transvaginal NOTES for the diagnosis of unexplained ascites is feasible, effective, and safe. This method had no long-term effect on female sexual function and is particularly suitable for women who have special aesthetic requirements. (Clinical trial registration number: ChiCTR-TRC-10001053.).


Assuntos
Ascite/diagnóstico , Laparoscopia/métodos , Cirurgia Endoscópica por Orifício Natural/métodos , Peritonite Tuberculosa/diagnóstico , Vagina/cirurgia , Adulto , Ascite/etiologia , Biópsia , Dispareunia/epidemiologia , Estudos de Viabilidade , Feminino , Gastroscópios , Humanos , Pessoa de Meia-Idade , Duração da Cirurgia , Peritonite Tuberculosa/complicações , Pneumoperitônio , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , Vaginite/epidemiologia
18.
Surg Endosc ; 33(2): 612-619, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30421083

RESUMO

AIM: To establish the clinical value of endoscopic papillectomy for duodenal papillary tumor based on endoscopic and clinical characteristics. PATIENTS AND METHODS: This single-center, retrospective study included 110 patients with duodenal papillary tumor who underwent endoscopic papillectomy between January 2006 and April 2017 at the gastrointestinal endoscopic center of the Chinese PLA General Hospital. Clinical data, postoperative pathology, procedure-related complications, and therapeutic outcomes were analyzed. RESULTS: Endoscopic papillectomy was technically feasible in all patients, and was mainly performed by four experienced endoscopists. The primary success rate of endoscopic papillectomy for ampullary neoplasms was 78.2%. A total of 13 patients experienced recurrence during a mean follow-up period of 16.28 months (range 6-132 months), the predictive factors that were related to recurrence were complete resection (53.8% vs. 94.2%; P = 0.001), and final pathology findings (P = 0.001). Delayed hemorrhage, the most common procedure-related complication, occurred in 20% (22/110) of patients and was significantly related to intraoperative bleeding (P = 0.042). Pancreatitis was the second most common complication, which was closely related to intraoperative bleeding requiring intervention (P = 0.040) and larger tumor size (P = 0.044). Histology, type of resection, stent placement, sphincterotomy, and duration of procedure were not related to post-procedure hemorrhage or pancreatitis. Older age (63.7 ± 13.5 vs. 57.4 ± 12.2; P = 0.033), jaundice (47.8% vs. 13.8%; P = 0.001), endoscopic forceps biopsy diagnosis of high-grade intraepithelial neoplasia (82.6% vs. 14.9%; P = 0.001), tumor size ≥ 2 cm (60.9% vs. 34.5%; P = 0.022), and dilation of the bile duct (34.8% vs. 9.2%; P = 0.006) were clinical features for ampullary carcinoma. The rate of complete resection (52.2% vs. 92.0%; P = 0.001) and recurrence (34.8% vs. 6.8%; P = 0.001) were also related to the diagnosis of ampullary carcinoma at final pathology. CONCLUSIONS: Endoscopic papillectomy is a feasible and reasonable option for both diagnosis and treatment of tumors of the duodenal papilla in properly selected patients.


Assuntos
Ampola Hepatopancreática , Neoplasias Duodenais , Endoscopia do Sistema Digestório , Adulto , Idoso , Ampola Hepatopancreática/patologia , Ampola Hepatopancreática/cirurgia , Biópsia/métodos , Neoplasias Duodenais/patologia , Neoplasias Duodenais/cirurgia , Endoscopia do Sistema Digestório/efeitos adversos , Endoscopia do Sistema Digestório/métodos , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Resultado do Tratamento
19.
Sci Rep ; 8(1): 13817, 2018 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-30217998

RESUMO

The characteristics of the gastric microbiota in patients with gastric polyposis (GP) remain unclear. Given this we collected gastric antrum and gastric body biopsies from healthy controls (HC.A and HC.B group) and gastric antrum, gastric body and polyp biopsies from patients with multiple gastric polyps (GP.A, GP.B and GP.P group) for 16S rDNA sequencing. The results showed that the diversity of the gastric flora in the GP group was significantly lower than that of the HC group. The gastric flora composition of the GP group was significantly different from the HC group. However, flora diversity and compositions in different parts of the stomach (gastric antrum, gastric body or polyp tissue) were not significantly different. H. pylori abundance could influence the composition of gastric microbiota. Meanwhile, patients with fundic gland polyps (FGPs) and those with hyperplastic polyps (HPs) had considerably similar gastric bacterial compositions. We constructed a microbial dysbiosis index (MDI) based on the gastric microbiota at the genus level as a predictive model, and it was able to distinguish between individuals in the GP and HC groups. These findings showed that intragastric flora dysbiosis may be closely related to the occurrence and development of gastric polyps.


Assuntos
Pólipos Adenomatosos/patologia , Mucosa Gástrica/microbiologia , Mucosa Gástrica/patologia , Neoplasias Gástricas/patologia , Polipose Adenomatosa do Colo/patologia , Pólipos Adenomatosos/microbiologia , Adulto , Idoso , Biópsia , China , Feminino , Fundo Gástrico/patologia , Microbioma Gastrointestinal , Helicobacter pylori , Humanos , Masculino , Microbiota , Pessoa de Meia-Idade , Pólipos/patologia , Antro Pilórico/patologia , Estômago/patologia , Neoplasias Gástricas/microbiologia
20.
Thorac Cancer ; 9(11): 1544-1555, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30221470

RESUMO

Acquired respiratory-digestive tract fistulas occur with abnormal communication between the airways and digestive tract, causing the interflow of gas and liquid. Despite advances in surgical methods and the development of multimodal therapy in recent years, patients with acquired respiratory-digestive tract fistulas continue to exhibit unfavorable clinical outcomes. Therefore, in order to guide clinical practice in China, the Respiratory and Cancer Intervention Alliance of the Beijing Health Promotion Association organized a group of experienced experts in the field to develop this consensus document. Based on a study of clinical application and expert experience in the diagnosis and management of acquired respiratory-digestive tract fistulas at home and abroad, an Expert Consensus was developed. The panelists recruited comprised experts in pulmonology, oncology, thoracic surgery, interventional radiology, and gastroenterology. PubMed, Chinese Biology Abstract, Chinese Academic Journal, and Wanfang databases were used to identify relevant articles. The guidelines address etiology, classification, pathogenesis, diagnosis and management of acquired respiratory-digestive tract fistulas. The statements on treatment focus on the indications for different procedures, technical aspects, and preprocedural, post-procedural and complication management. The proposed guidelines for the diagnosis and management of acquired respiratory-digestive tract fistulas are the first to be published by Chinese experts. These guidelines provide an in-depth review of the current evidence and standard of diagnosis and management.


Assuntos
Consenso , Fístula/diagnóstico , Fístula/terapia , Trato Gastrointestinal/anormalidades , Sistema Respiratório/fisiopatologia , China , Feminino , Fístula/patologia , Humanos , Masculino
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