AIM： To retrospectively investigate the effect and safety of various new type precut sphincterotomy techniques （VNTPST） in endoscopic retrograde cholangiopancreatography （ERCP） due to difficult biliary duct cannu...AIM： To retrospectively investigate the effect and safety of various new type precut sphincterotomy techniques （VNTPST） in endoscopic retrograde cholangiopancreatography （ERCP） due to difficult biliary duct cannulation （DBC）. METHODS： A plough-like pull-type sphincterotome （PLPTS） or improved short nose sphincterotome or improved needle knife was applied. VNTPST was carried out in 30 of 280 patients, whose biliary tract could not be exposed well or deep cannulation was difficult to perform during ERCP with traditional methods. Patients were followed up for short-term complications and the therapeutic effect of VNTPS was observed and compared with that of traditional endoscopic sphincterotomy （EST）. RESULTS： A total 280 patients underwent ERCP, of which 3 failed in operation because of pathological features in stomch or duodenum, 247 successfully underwent traditional ERCP （89.1%, 247/277）, 30 failed （10.8%, 30/277）. VNTPS technique succeeded in 24 （80%, 24/30） of 30 cases. The successful rate of deep biliary duct cannulation increased 8.6% （24/277）, the total cannulation successful rate following precut was 97.7%. There was a significant difference between the two groups （97.7% vs 89.1%, x^2= 17.1, P 〈 0.01）. The incidence of complications was 9.3% （26/277） for traditional ERCP group and 13.3% （4/30） for VNTPS technique group. Guideline tip was broken in pancreatic duct （KPDGP） of one patient, and there was no pancreatitis, slight or moderate bleeding postoperatively occurred in 2 patients, 1 patient had bleeding during operation （PDWN）. There were no differences between VNTPS technique group and traditional ERCP（TRERCP）group （13.3% vs 9.3%, %2 = 0.478, P 〉 0.05）. CONCLUSION： VNTPS procedure and Deng＇s precut are highly effective methods to get biliary access during ERCP with DBC. With skillful techniques, it can increase the successful rate for deep cannulation of biliary duct and decrease complications. VNTPS technique, especially Deng＇s precut is as effective and safe as EST. This technique can be well performed in hospitals without particular equipments.展开更多
AIM To compare long-term occurrence of gastroesophageal reflux disease(GERD) between two different types of peroral endoscopic myotomy(POEM) for achalasia.METHODS We included all patients with achalasia who underwent ...AIM To compare long-term occurrence of gastroesophageal reflux disease(GERD) between two different types of peroral endoscopic myotomy(POEM) for achalasia.METHODS We included all patients with achalasia who underwent POEM at our hospital from August 2011 to October 2012 and had complete GERD evaluation with ≥ 3 years of follow-up. They were divided into circular or full-thickness myotomy groups according to the depth of myotomy. Demographics, Eckardt score, manometry results, 24-h pH monitoring, and GERD symptoms were recorded and compared between the two groups.RESULTS We studied 56 patients(32 circular myotomy and 24 fullthickness myotomy) with complete GERD evaluation. There was no significant difference between the two groups in terms of treatment success(defined as Eckardt score ≤ 3), postoperative Eckardt score, mean basal lower esophageal sphincter pressure, and 4-s integrated relaxation pressure(4s IRP). Postoperative abnormal esophageal acid exposure was found in 25 patients(44.6%). A total of 13 patients(23.2%) had GERD symptoms and 12 had esophagitis(21.4%). Clinically relevant GERD(abnormal esophageal acid exposure associated with GERD symptoms and/or esophagitis) was diagnosed in 13 patients(23.2%).Multivariate analysis revealed that full-thickness myotomy and low level of postoperative 4s IRP were predictive factors for clinically relevant GERD.CONCLUSION Efficacy and manometry are comparable between achalasia patients treated with circular or full-thickness myotomy. But patients with full-thickness myotomy and low postoperative 4sI RP have more GERD.展开更多
In this work, new composite membranes were successfully prepared via phase inversion technique using polyvinyl chloride(PVC) and polyvinylpyrrolidone(PVP) as polymers and tetrahydrofuran(THF) and N-methyl-2-pyrrolidon...In this work, new composite membranes were successfully prepared via phase inversion technique using polyvinyl chloride(PVC) and polyvinylpyrrolidone(PVP) as polymers and tetrahydrofuran(THF) and N-methyl-2-pyrrolidone(NMP) as solvents. The prepared membranes have been characterized by scanning electron microscope(SEM), and fourier transforms infrared spectroscopy(FTIR). The scanning electron microscope results prove that the prepared membranes are smooth and their pores are distributed throughout the whole surface and bulk body of the membrane without any visible cracks. The stress–strain mechanical test showed an excellent mechanical behavior enhanced by the presence of PVP in the prepared membranes. The membranes performance results showed that the salt rejection reached 98% with a high flux. This, in turn, makes the prepared membranes can be applied for sea and brackish water treatment through membrane distillation technology.展开更多
It is an important challenge to make disk-like polymeric nanostructures. Herein we report a facile method for preparing polymer nanodisks by self-collapse of nanocapsules self-assembled from a statistical copolymer af...It is an important challenge to make disk-like polymeric nanostructures. Herein we report a facile method for preparing polymer nanodisks by self-collapse of nanocapsules self-assembled from a statistical copolymer after partial hydrolysis. We find that partial hydrolysis of the statistical copolymer is crucial for the formation of nanodisks as it affords a suitable rigidity for the membrane of nanocapsules. The nanodisk structure has been confirmed by transmission electron microscopy(TEM), scanning electron microscopy(SEM) and atomic force microscopy(AFM) studies with a thickness of 6.3±0.2 nm. Overall, our results demonstrated a new method for making disk-like nano-objects.展开更多
文摘AIM： To retrospectively investigate the effect and safety of various new type precut sphincterotomy techniques （VNTPST） in endoscopic retrograde cholangiopancreatography （ERCP） due to difficult biliary duct cannulation （DBC）. METHODS： A plough-like pull-type sphincterotome （PLPTS） or improved short nose sphincterotome or improved needle knife was applied. VNTPST was carried out in 30 of 280 patients, whose biliary tract could not be exposed well or deep cannulation was difficult to perform during ERCP with traditional methods. Patients were followed up for short-term complications and the therapeutic effect of VNTPS was observed and compared with that of traditional endoscopic sphincterotomy （EST）. RESULTS： A total 280 patients underwent ERCP, of which 3 failed in operation because of pathological features in stomch or duodenum, 247 successfully underwent traditional ERCP （89.1%, 247/277）, 30 failed （10.8%, 30/277）. VNTPS technique succeeded in 24 （80%, 24/30） of 30 cases. The successful rate of deep biliary duct cannulation increased 8.6% （24/277）, the total cannulation successful rate following precut was 97.7%. There was a significant difference between the two groups （97.7% vs 89.1%, x^2= 17.1, P 〈 0.01）. The incidence of complications was 9.3% （26/277） for traditional ERCP group and 13.3% （4/30） for VNTPS technique group. Guideline tip was broken in pancreatic duct （KPDGP） of one patient, and there was no pancreatitis, slight or moderate bleeding postoperatively occurred in 2 patients, 1 patient had bleeding during operation （PDWN）. There were no differences between VNTPS technique group and traditional ERCP（TRERCP）group （13.3% vs 9.3%, %2 = 0.478, P 〉 0.05）. CONCLUSION： VNTPS procedure and Deng＇s precut are highly effective methods to get biliary access during ERCP with DBC. With skillful techniques, it can increase the successful rate for deep cannulation of biliary duct and decrease complications. VNTPS technique, especially Deng＇s precut is as effective and safe as EST. This technique can be well performed in hospitals without particular equipments.
基金Supported by the Development and Reform Commission of Hunan Province,China,No.XFGTZ2014713
文摘AIM To compare long-term occurrence of gastroesophageal reflux disease(GERD) between two different types of peroral endoscopic myotomy(POEM) for achalasia.METHODS We included all patients with achalasia who underwent POEM at our hospital from August 2011 to October 2012 and had complete GERD evaluation with ≥ 3 years of follow-up. They were divided into circular or full-thickness myotomy groups according to the depth of myotomy. Demographics, Eckardt score, manometry results, 24-h pH monitoring, and GERD symptoms were recorded and compared between the two groups.RESULTS We studied 56 patients(32 circular myotomy and 24 fullthickness myotomy) with complete GERD evaluation. There was no significant difference between the two groups in terms of treatment success(defined as Eckardt score ≤ 3), postoperative Eckardt score, mean basal lower esophageal sphincter pressure, and 4-s integrated relaxation pressure(4s IRP). Postoperative abnormal esophageal acid exposure was found in 25 patients(44.6%). A total of 13 patients(23.2%) had GERD symptoms and 12 had esophagitis(21.4%). Clinically relevant GERD(abnormal esophageal acid exposure associated with GERD symptoms and/or esophagitis) was diagnosed in 13 patients(23.2%).Multivariate analysis revealed that full-thickness myotomy and low level of postoperative 4s IRP were predictive factors for clinically relevant GERD.CONCLUSION Efficacy and manometry are comparable between achalasia patients treated with circular or full-thickness myotomy. But patients with full-thickness myotomy and low postoperative 4sI RP have more GERD.
文摘In this work, new composite membranes were successfully prepared via phase inversion technique using polyvinyl chloride(PVC) and polyvinylpyrrolidone(PVP) as polymers and tetrahydrofuran(THF) and N-methyl-2-pyrrolidone(NMP) as solvents. The prepared membranes have been characterized by scanning electron microscope(SEM), and fourier transforms infrared spectroscopy(FTIR). The scanning electron microscope results prove that the prepared membranes are smooth and their pores are distributed throughout the whole surface and bulk body of the membrane without any visible cracks. The stress–strain mechanical test showed an excellent mechanical behavior enhanced by the presence of PVP in the prepared membranes. The membranes performance results showed that the salt rejection reached 98% with a high flux. This, in turn, makes the prepared membranes can be applied for sea and brackish water treatment through membrane distillation technology.
基金supported by the National Natural Science Foundation of China(21674081,21611130175)Shanghai International Scientific Collaboration Fund(15230724500)+1 种基金Shanghai 1000 Talents Planthe Fundamental Research Funds for the Central Universities(1500219107)
文摘It is an important challenge to make disk-like polymeric nanostructures. Herein we report a facile method for preparing polymer nanodisks by self-collapse of nanocapsules self-assembled from a statistical copolymer after partial hydrolysis. We find that partial hydrolysis of the statistical copolymer is crucial for the formation of nanodisks as it affords a suitable rigidity for the membrane of nanocapsules. The nanodisk structure has been confirmed by transmission electron microscopy(TEM), scanning electron microscopy(SEM) and atomic force microscopy(AFM) studies with a thickness of 6.3±0.2 nm. Overall, our results demonstrated a new method for making disk-like nano-objects.
