To demonstrate the clinical outcomes of a multicenter experience and to suggest guidelines for choosing a suction method.METHODSThis retrospective study at 5 medical centers involved 58 consecutive patients undergoing...To demonstrate the clinical outcomes of a multicenter experience and to suggest guidelines for choosing a suction method.METHODSThis retrospective study at 5 medical centers involved 58 consecutive patients undergoing over-the-scope clips (OTSCs) placement. The overall rates of technical success (TSR), clinical success (CSR), complications, and procedure time were analyzed as major outcomes. Subsequently, 56 patients, excluding two cases that used the Anchor device, were divided into two groups: 14 cases of simple suction (SS-group) and 42 cases using the Twin Grasper (TG-group). Secondary evaluation was performed to clarify the predictors of OTSC success.RESULTSThe TSR, CSR, complication rate, and median procedure time were 89.7%, 84.5%, 1.8%, and 8 (range 1-36) min, respectively, demonstrating good outcomes. However, significant differences were observed between the two groups in terms of the mean procedure time (5.9 min vs 14.1 min). The CSR of the SS- and TG-groups among cases with a maximum defect size ≤ 10 mm and immediate or acute refractory bleeding was 100%, which suggests that SS is a better method than TG in terms of time efficacy. The CSR in the SS-group (78.6%), despite the technical success of the SS method (TSR, 100%), tended to decrease due to delayed leakage compared to that in the TG-group (TSR, CSR; 88.1%), indicating that TG may be desirable for leaks and fistulae with defects of the entire layer.CONCLUSIONOTSC system is a safe and effective therapeutic option for gastrointestinal defects. Individualized selection of the suction method based on particular clinical conditions may contribute to the improvement of OTSC success.展开更多
We read the original article by Nuis, et al. and the reply by Dogan, et al. with great interest. Nuis, et al. examined whether transcatheter aortic valve implantation （TAVI） in patients suffering from severe aortic ...We read the original article by Nuis, et al. and the reply by Dogan, et al. with great interest. Nuis, et al. examined whether transcatheter aortic valve implantation （TAVI） in patients suffering from severe aortic stenosis led to changes in corrected QT dispersion （cQTD）, previously used to predict arrhythmic risk. Dogan, et al. proposed that a different marker, transmural dispersion of repolariza- tion （TDR）, has better accuracy in risk prediction.展开更多
Psoriatic arthritis(PsA) is a rheumatoid factor(RF)-seronegative systemic inflammatory disorder associated with psoriasis.Current treatment for PsA in China is still focused on disease modifying anti-rheumatic drugs(D...Psoriatic arthritis(PsA) is a rheumatoid factor(RF)-seronegative systemic inflammatory disorder associated with psoriasis.Current treatment for PsA in China is still focused on disease modifying anti-rheumatic drugs(DMARDs).In this paper,we report two Chinese patients with active longstanding PsA treated with infliximab,a human-mouse chimeric monoclonal antibody against tumor necrosis factor alpha(TNF-α).The results show that infliximab acted quickly and effectively in relieving peripheral and axial symptoms and refractory skin lesions,even in recombinant human TNF-α receptor(rhTNFR)-resistant case.The take-home message from our cases is that infliximab is a useful therapeutic option for refractory PsA,especially when a patient has a combination of psoriasis and psoriatic arthritis.Further local evidence and experience must be accumulated in order to make anti-TNF-α therapy more accessible to PsA patients in China.展开更多
文摘To demonstrate the clinical outcomes of a multicenter experience and to suggest guidelines for choosing a suction method.METHODSThis retrospective study at 5 medical centers involved 58 consecutive patients undergoing over-the-scope clips (OTSCs) placement. The overall rates of technical success (TSR), clinical success (CSR), complications, and procedure time were analyzed as major outcomes. Subsequently, 56 patients, excluding two cases that used the Anchor device, were divided into two groups: 14 cases of simple suction (SS-group) and 42 cases using the Twin Grasper (TG-group). Secondary evaluation was performed to clarify the predictors of OTSC success.RESULTSThe TSR, CSR, complication rate, and median procedure time were 89.7%, 84.5%, 1.8%, and 8 (range 1-36) min, respectively, demonstrating good outcomes. However, significant differences were observed between the two groups in terms of the mean procedure time (5.9 min vs 14.1 min). The CSR of the SS- and TG-groups among cases with a maximum defect size ≤ 10 mm and immediate or acute refractory bleeding was 100%, which suggests that SS is a better method than TG in terms of time efficacy. The CSR in the SS-group (78.6%), despite the technical success of the SS method (TSR, 100%), tended to decrease due to delayed leakage compared to that in the TG-group (TSR, CSR; 88.1%), indicating that TG may be desirable for leaks and fistulae with defects of the entire layer.CONCLUSIONOTSC system is a safe and effective therapeutic option for gastrointestinal defects. Individualized selection of the suction method based on particular clinical conditions may contribute to the improvement of OTSC success.
文摘We read the original article by Nuis, et al. and the reply by Dogan, et al. with great interest. Nuis, et al. examined whether transcatheter aortic valve implantation （TAVI） in patients suffering from severe aortic stenosis led to changes in corrected QT dispersion （cQTD）, previously used to predict arrhythmic risk. Dogan, et al. proposed that a different marker, transmural dispersion of repolariza- tion （TDR）, has better accuracy in risk prediction.
文摘Psoriatic arthritis(PsA) is a rheumatoid factor(RF)-seronegative systemic inflammatory disorder associated with psoriasis.Current treatment for PsA in China is still focused on disease modifying anti-rheumatic drugs(DMARDs).In this paper,we report two Chinese patients with active longstanding PsA treated with infliximab,a human-mouse chimeric monoclonal antibody against tumor necrosis factor alpha(TNF-α).The results show that infliximab acted quickly and effectively in relieving peripheral and axial symptoms and refractory skin lesions,even in recombinant human TNF-α receptor(rhTNFR)-resistant case.The take-home message from our cases is that infliximab is a useful therapeutic option for refractory PsA,especially when a patient has a combination of psoriasis and psoriatic arthritis.Further local evidence and experience must be accumulated in order to make anti-TNF-α therapy more accessible to PsA patients in China.
