Radiation proctopathy, which can be categorized as acute and chronic, is defined as the radiation damage to the rectum caused by radiation therapy in patients with pelvic malignancies. Chronic radiation proctopathy can cause complications such as rectal bleeding, which severely affects patients’ quality of life. At present, endoscopic therapy has become the primary method for diagnosis and treatment of bleeding from chronic radiation proctopathy. In October 2019, the American Society for Gastrointestinal Endoscopy (ASGE) published "ASGE guideline on the role of endoscopy for bleeding from chronic radiation". The guideline described the effectiveness and safety of different endoscopic therapies such as argon plasma coagulation, bipolar electrocoagulation, heater probe, radiofrequency ablation, cryoablation, etc. in the treatment of bleeding from chronic radiation. This paper interprets it to provide references for clinicians in the treatment of bleeding from chronic radiation.
Endoscopic retrograde cholangiopancreatography (ERCP) is currently the first-line minimally invasive diagnosis and treatment of biliary and pancreatic diseases. With the increasing popularity of ERCP, ERCP-related adverse events which include post-ERCP pancreatitis, cholecystitis, cholangitis, bleeding, perforation, etc., have received more and more attention. In response to the controversy and problems in the management of these adverse events, the European Society of Gastrointestinal Endoscopy published the guidelines for ERCP-related adverse events in December 2019. The paper interprets the key points in the guideline to provide references for clinical practice.
In February 2020, the American College of Gastroenterology (ACG) published the latest guideline on chronic pancreatitis, and put forward practical recommendations on the etiology, natural history, diagnosis, treatment, prognosis and follow-up of chronic pancreatitis. This paper aims to provide references for the diagnosis and treatment of chronic pancreatitis in China by interpreting the main content of the guideline and comparing it with related guidelines or consensuses domestically and abroad.
Objective To discuss the clinical effect of repairing soft tissue defects in cnemis,ankle and foot with calf and sural distal fasciocutaneous flaps. Methods From August 1998 to July 2004, 34 cases of soft tissue defects in cnemis, ankles and feet were repaired with calf and sural distal fasciocutaneous flaps. There were 27 males and 7 females, aging from 17 to 61 years and the disease course was 4 hours to 8 months. The locations were metainferior segment of cnemis in 18 cases, ankle and foot in 11cases, weight loading region of calcar pedis in 5 cases. There were 13 cases chronic osteomyelitis in tibia or calcaneal bone, 8 cases of raw surface was infected, 3 cases of bone exposure.The sizes of the flap ranged from 6 cm×4 cm to 15 cm×12 cm. Results Thirty-one flaps survived except 3 cases which had partial necrosis. They were followed up from 6 months to 12 months. Both the quality and the appearance of the flaps were satisfactory. The blood supply and function of cnemis, ankle and foot returned to normal. Conclusion It is a convenient, simple and reliable method to repair softtissue defects in cnemis, ankle and foot with calf and sural distal fasciocutaneous flaps,without sacrifice of major arteries and with high survival rate and beautiful outlook form of skin flaps.
Acute nonvariceal upper gastrointestinal bleeding (ANVUGIB) is one of the most common emergencies of the digestive system. With the continuous development of digestive endoscopy technology and widespread use of proton pump inhibitors, the morbidity and mortality of ANVUGIB have declined, but there are still numerous difficulties to be solved in clinical treatment. The International Consensus Group in 2019 updated the international consensus guideline in 2003 and 2010 with new clinical recommendations on fluid resuscitation, risk assessment, pre-endoscopic treatment, endoscopic treatment, drug therapy, and secondary prevention, etc. This paper interprets the update to provide references for the clinical treatment of ANVUGIB.
ObjectiveTo discuss the effect of the whole-course management model of intermittent catheterization (IC) in patients with neurogenic bladder (NB).MethodsPatients with NB caused by incomplete spinal cord injury admitted to Department of Rehabilitation Medicine of West China Hospital of Sichuan University between May and October 2019 were selected. According to the random number table, the patients were randomly divided into the trial group and the control group. The control group adopted the traditional management mode of IC, and the trial group adopted the whole-course management mode of IC. The urination diary (single catheterization volume, residual urine volume, and times of urine leakage), bacteria count and leukocyte count in urine routine were compared between the two groups.ResultsFinally 80 patients were included, with 40 cases in each group. There was no significant difference in urination diary, bacteria count or leukocyte count in urine routine between the two groups (P>0.05). There was no significant difference between the two groups in urination diary in the second week of management (P>0.05). At the 12th week of management, there were statistically significant differences in urination diary between the two groups (P<0.05). The bacteria count and leukocyte count in the second and 12th week of the management in the trial group were lower than those in the control group (P<0.05).ConclusionsThe whole-course management of IC for patients with NB caused by incomplete spinal cord injury can effectively improve bladder volume, and reduce residual urine volume and times of urine leakage. It also can reduce the incidence of urinary tract infection, reduce urinary complications, and ultimately improve the quality of life of patients.
ObjectiveTo construct a hepatocellular carcinoma (HCC) cell line stably transfected with linamarase (lis) gene from cassava, and to study its biological characteristics. MethodsLis DNA was amplified from cassava by PCR and cloned into the pcDNA3.1(+) plasmid. Then the recombinant plasmid pcDNA3.1/lis was transfected into human HCC HepG2 cell line using lipofectamineTM 2000 and G418 selection. The stably transfected cell lines HepG2/lis was identified by immunofluorescence, RT-PCR, and Western blot. The enzyme activity of lis in cells was assayed by Lambert method. The characteristics of the new cell lines were checked by several methods: the cell growth curve was observed by MTT, cell cycle was analyzed by flow cytometry, and characteristics of tumor formation in vivo were detected in nude mice. ResultsLis from the cassava could stably integrate into eukaryotic cells, and package the same protein as lis with β-glucosidase activity. The stable integration of lis in cells did not interfere with cell morphology, growth characteristics, cell cycle, and tumorigenesis in vivo significantly. ConclusionsA new HCC cell lines transfected with lis is successfully established, which may lay an experimental foundation for the study of HCC treatment by using lis suicide gene system in future.
Objective To investigate the biocompatibility of type I collagen scaffold with rat bone marrow mesenchymal stem cell (BMSCs) and its role on proliferation and differentiation of BMSCs so as to explore the feasibility of collagen scaffold as neural tissue engineering scaffold. Methods Type I collagen was used fabricate collagen scaffold. BMSCs were isolated by density gradient centrifugation. The 5th passage cells were used to prepare the collagen scaffold-BMSCs complex. The morphology of collagen scaffold and BMSCs was observed by scanning electron microscope (SEM) and HE staining. The cell proliferation was measured by MTT assay at 1, 3, 5, and 7 days after culturein vitro. After cultured on collagen scaffold for 24 hours, the growth and adhesion of green fluorescent protein positive (GFP+) BMSCs were observed by confocal microscopy and live cell imaging. Results The confocal microscopy and live cell imaging results showed that GFP+ BMSCs uniformly distributed in the collagen scaffold; cells were fusiform shaped, and cell process or junctions between the cells formed in some cells, indicating good cell growth in the collagen scaffold. Collagen scoffold had porous fiber structure under SEM; BMSCs could adhered to the scaffold, with good cell morphology. The absorbance (A) value of BMSCs on collagen scaffold at 5 and 7 days after culture was significantly higher than that of purely-cultured BMSCs (t=4.472,P=0.011;t=4.819,P=0.009). HE staining showed that collagen scaffold presented a homogeneous, light-pink filament like structure under light microscope. BMSCs on the collagen scaffold distributed uniformly at 24 hours; cell displayed various forms, and some cells extended multiple processes at 7 days, showing neuron-like cell morphology. Conclusion Gelatinous collagen scaffold is easy to prepare and has superior biocompatibility. It is a promising scaffold for neural tissue engineering.
ObjectiveTo systematically review the effect of clamping catheter and free drainage for patients with neurogenic bladder with indwelling catheter. MethodsThe PubMed, EMbase, CINAHL, EBSCO, Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) related to the objects from inception to January 8, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 software. ResultsA total of 7 RCTs involving 586 patients were included. Meta-analysis showed that clamping catheter significantly reduced time of first void (SMD=−1.03, 95%CI −1.71 to −0.36, P=0.03) and increased volume of first void (MD=52.72, 95%CI 28.84 to 76.59, P<0.01). However, there was no significant difference in residual urine volume, incidence of urinary retention or urinary tract infection between the two groups. ConclusionCurrent evidence shows that the advantage of clamping catheter for patients with neurogenic bladder with indwelling catheter is not obvious. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
To establ ish a simple and stable cervical ectopic renal transplantation rat model that increase surgical successful rate. Methods A total of 208 male inbred Wistar rats (weighing 220-260 g) were randomly served as donors and recipients. The graft consisting of kidney, renal vein (RV) and renal artery (RA) was obtained, and perfused in situ. The donor RA was end-to-end anastomosed to the recipient left common carotid artery (CCA) by using of “sleeve” anastomosis,and the donor RV to the recipient right external jugular vein by using of “cuff” technique. The distal end of the ureter wasbrought out to form cervical cutaneous stomas. Results A total of 104 ectopic renal transplantations were performed in rats, including stages of the pre-experiment (62 operations) and experiment (42 operations). The success rates of the two stages were 80.6% and 95.2%, respectively. The causes of failure in the pre-experimental stage were anesthesia accidents, thrombosis of the arterial anastomosis, massive hemorrhage, air embol ism and phlebemphraxis. In the experimental stage, 2 rats died due to late anastomotic hemorrhage and thrombosis. The remaining 40 transplanted kidney survived more than 6 months. The time for surgery was (40 ± 6) minutes, the average time for donor surgery was (20 ± 5) minutes, the preparation time for the graft was (8 ± 2) minutes, the operative time for the recipient was (18 ± 3) minutes, including the time for the arterial anastomosis (5 ± 2) minutes and venous anastomosis (2 ± 1) minutes, the cold ischemia time of graft was (15 ± 3) minutes. Conclusion The cervical ectopic renal transplantation technique has the advantages of easy-and fast-to-perform, shorter operation and cold ischemia time, higher successful rate.