Oesophageal Mycosis: Epidemiological and Clinical Aspects and Risk Factors for Occurrence in the Digestive Endoscopy Unit of the Donka National Hospital, Conakry CHU

Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompetent subjects. The aim of this study was to determine the endoscopic prevalence, clinical characteristics and risk factors for the occurrence of oesophageal mycosis in our department. Patients and Method: This was a prospective cross-sectional study of all patients who underwent oeso-gastroduodenal fibroscopy during the period from 1st January to 31st December 2022, i.e. one year, at the digestive endoscopy unit of the hepato-gastroenterology department of the Donka CHU national hospital in Conakry. All patients found to have oesophageal mycosis by FOGD were included. The endoscopy was performed using appropriate equipment: A Fujinon 4400 video endoscopy column;Three Fujinon EG 590 video gastroscopes;A hoover;Data were collected using a pre-established survey form and analysed using Epi info software version 6.0.4;Pearson’s Chi2 test as a test of independence and the exact 5% threshold ficher test. Results: Out of 1343 upper gastrointestinal endoscopies performed, 107 cases of oesophageal mycosis were found, representing a prevalence of 7.96%. The mean age was 40 years, with a male predominance of 55.42%. The sex ratio M/F was 1.24. The 45 and over age group was the most affected, with a prevalence of 40.43%, followed by the [35 - 45] age group, with a prevalence of 22.43%. Clinical symptoms were dominated by epigastralgia in 74.76% of cases, followed by odynophagia in 37.38% of cases, nausea and vomiting in 28.03% of cases, and pyrosis in 26.16% of cases. Oesophageal mycosis without oesophagitis was the most common endoscopic finding in 70% of cases. The main associated endoscopic lesions were erythemato-erosive and congestive gastropathy in 28.03% of cases, peptic oesophagitis (9.34%) and gastric ulcer (5.60%). The main risk factors found were positive HIV serology in 39.25% of cases, and diabetes in 24.30% of cases, with a statistically significant relationship of 0.02 and 0.01 respectively. Conclusion: Oesophageal mycosis is the most common opportunistic infection in patients with impaired cellular immunity. The prevalence of oesophageal mycosis in our series was 7.96%. This study enabled us to identify the main risk factors for the occurrence of oesophageal mycosis. Our country needs to step up its programme to combat and prevent immunodeficiency diseases, particularly HIV and diabetes.

Standard-definition White-light,High-definition White-light versus Narrow-band Imaging Endoscopy for Detecting Colorectal Adenomas:A Multicenter Randomized Controlled Trial

Objective This study aimed to compare the performance of standard-definition white-light endoscopy(SD-WL),high-definition white-light endoscopy(HD-WL),and high-definition narrow-band imaging(HD-NBI)in detecting colorectal lesions in the Chinese population.Methods This was a multicenter,single-blind,randomized,controlled trial with a non-inferiority design.Patients undergoing endoscopy for physical examination,screening,and surveillance were enrolled from July 2017 to December 2020.The primary outcome measure was the adenoma detection rate(ADR),defined as the proportion of patients with at least one adenoma detected.The associated factors for detecting adenomas were assessed using univariate and multivariate logistic regression.Results Out of 653 eligible patients enrolled,data from 596 patients were analyzed.The ADRs were 34.5%in the SD-WL group,33.5%in the HD-WL group,and 37.5%in the HD-NBI group(P=0.72).The advanced neoplasm detection rates(ANDRs)in the three arms were 17.1%,15.5%,and 10.4%(P=0.17).No significant differences were found between the SD group and HD group regarding ADR or ANDR(ADR:34.5%vs.35.6%,P=0.79;ANDR:17.1%vs.13.0%,P=0.16,respectively).Similar results were observed between the HD-WL group and HD-NBI group(ADR:33.5%vs.37.7%,P=0.45;ANDR:15.5%vs.10.4%,P=0.18,respectively).In the univariate and multivariate logistic regression analyses,neither HD-WL nor HD-NBI led to a significant difference in overall adenoma detection compared to SD-WL(HD-WL:OR 0.91,P=0.69;HD-NBI:OR 1.15,P=0.80).Conclusion HD-NBI and HD-WL are comparable to SD-WL for overall adenoma detection among Chinese outpatients.It can be concluded that HD-NBI or HD-WL is not superior to SD-WL,but more effective instruction may be needed to guide the selection of different endoscopic methods in the future.Our study’s conclusions may aid in the efficient allocation and utilization of limited colonoscopy resources,especially advanced imaging technologies.

Detachable string magnetically controlled capsule endoscopy for the noninvasive diagnosis of esophageal diseases:A prospective,blind clinical study

BACKGROUND Traditional esophagogastroduodenoscopy(EGD),an invasive examination method,can cause discomfort and pain in patients.In contrast,magnetically controlled capsule endoscopy(MCE),a noninvasive method,is being applied for the detection of stomach and small intestinal diseases,but its application in treating esophageal diseases is not widespread.AIM To evaluate the safety and efficacy of detachable string MCE(ds-MCE)for the diagnosis of esophageal diseases.METHODS Fifty patients who had been diagnosed with esophageal diseases were pros-pectively recruited for this clinical study and underwent ds-MCE and conven-tional EGD.The primary endpoints included the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of ds-MCE for patients with esophageal diseases.The secondary endpoints consisted of visualizing the esophageal and dentate lines,as well as the subjects'tolerance of the procedure.RESULTS Using EGD as the gold standard,the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of ds-MCE for esophageal disease detection were 85.71%,86.21%,81.82%,89.29%,and 86%,respectively.ds-MCE was more comfortable and convenient than EGD was,with 80%of patients feeling that ds-MCE examination was very comfortable or comfortable and 50%of patients believing that detachable string v examination was very convenient.CONCLUSION This study revealed that ds-MCE has the same diagnostic effects as traditional EGD for esophageal diseases and is more comfortable and convenient than EGD,providing a novel noninvasive method for treating esophageal diseases.

In vivo pilot study into superficial microcirculatory characteristics of colorectal adenomas using novel high-resolution magnifying endoscopy with blue laser imaging

BACKGROUND No studies have yet been conducted on changes in microcirculatory hemody-namics of colorectal adenomas in vivo under endoscopy.The microcirculation of the colorectal adenoma could be observed in vivo by a novel high-resolution magnification endoscopy with blue laser imaging(BLI),thus providing a new insight into the microcirculation of early colon tumors.AIM To observe the superficial microcirculation of colorectal adenomas using the novel magnifying colonoscope with BLI and quantitatively analyzed the changes in hemodynamic parameters.METHODS From October 2019 to January 2020,11 patients were screened for colon adenomas with the novel high-resolution magnification endoscope with BLI.Video images were recorded and processed with Adobe Premiere,Adobe Photoshop and Image-pro Plus software.Four microcirculation parameters:Microcirculation vessel density(MVD),mean vessel width(MVW)with width standard deviation(WSD),and blood flow velocity(BFV),were calculated for adenomas and the surrounding normal mucosa.RESULTS A total of 16 adenomas were identified.Compared with the normal surrounding mucosa,the superficial vessel density in the adenomas was decreased(MVD:0.95±0.18 vs 1.17±0.28μm/μm2,P<0.05).MVW(5.11±1.19 vs 4.16±0.76μm,P<0.05)and WSD(11.94±3.44 vs 9.04±3.74,P<0.05)were both increased.BFV slowed in the adenomas(709.74±213.28 vs 1256.51±383.31μm/s,P<0.05).CONCLUSION The novel high-resolution magnification endoscope with BLI can be used for in vivo study of adenoma superficial microcirculation.Superficial vessel density was decreased,more irregular,with slower blood flow.

Could near focus endoscopy,narrow-band imaging,and acetic acid improve the visualization of microscopic features of stomach mucosa?

BACKGROUND Conventional magnifying endoscopy with narrow-band imaging(NBI)observation of the gastric body mucosa shows dominant patterns in relation to the regular arrangement of collecting venules,subepithelial capillary network,and gastric pits.AIM To evaluate the effectiveness of a new one-dual(near)focus,NBI mode in the assessment of the microscopic features of gastric body mucosa compared to conventional magnification.METHODS During 2021 and 2022,68 patients underwent proximal gastrointestinal endoscopy using magnification endoscopic modalities subsequently applying acetic acid(AA).The GIF-190HQ series NBI system with dual focus capability was used for the investigation of gastric mucosa.At the time of the endoscopy,the gastric body mucosa of all enrolled patients was photographed using the white light endoscopy(WLE),near focus(NF),NF-NBI,AA-NF,and AA-NF-NBI modes.RESULTS The WLE,NF and NF-NBI endoscopic modes for all patients(204 images)were classified in the same order into three groups.Two images from each patient for the AA-NF and AA-NF-NBI endoscopic modes were classified in the same order.According to all three observers who completed the work independently,NF magnification was significantly superior to WLE(P<0.01),and the NF-NBI mode was significantly superior to NF magnification(P<0.01).After applying AA,the three observers confirmed that AA-NF-NBI was significantly superior to AA-NF(P<0.01).Interobserver kappa values for WLE were 0.609,0.704,and 0.598,respectively and were 0.600,0.721,and 0.637,respectively,for NF magnification.For the NF-NBI mode,the values were 0.378,0.471,and 0.553,respectively.For AA-NF,they were 0.453,0.603,and 0.480,respectively,and for AA-NF-NBI,they were 0.643,0.506,and 0.354,respectively.CONCLUSION When investigating gastric mucosa in microscopic detail,NF-NBI was the most powerful endoscopic mode for assessing regular arrangement of collecting venules,subepithelial capillary network,and gastric pits among the five endoscopic modalities investigated in this study.AA-NF-NBI was the most powerful endoscopic mode for analyzing crypt opening and intervening part.

Impact of glucagon-like peptide receptor agonists on endoscopy and its preoperative management: Guidelines, challenges, and future directions

Glucagon-like peptide receptor agonists(GLP-1RA)are used to treat type 2 diabetes mellitus and,more recently,have garnered attention for their effect-iveness in promoting weight loss.They have been associated with several gastrointestinal adverse effects,including nausea and vomiting.These side effects are presumed to be due to increased residual gastric contents.Given the potential risk of aspiration and based on limited data,the American Society of Anesthesi-ologists updated the guidelines concerning the preoperative management of patients on GLP-1RA in 2023.They included the duration of mandated cessation of GLP-1RA before sedation and usage of“full stomach”precautions if these medications were not appropriately held before the procedure.This has led to additional challenges,such as extended waiting time,higher costs,and increased risk for patients.In this editorial,we review the current societal guidelines,clinical practice,and future directions regarding the usage of GLP-1RA in patients undergoing an endoscopic procedure.

大豆籽粒Ve含量的全基因组关联分析

维生素E(Ve)是大豆油中一种天然抗氧化剂,是评价大豆油营养价值的重要指标。本研究利用含有264份的大豆自然群体在2021年和2022年测定了籽粒中α-、γ-和δ-生育酚含量,并进行全基因组关联分析(Genome-wide association study,GWAS)。本研究共检测到199个与大豆Ve含量显著关联的SNP位点,其中9个可在2个环境或者2个性状被重复检测到,分别位于3号、7号、11号、12号、13号、15号、17号和18号染色体上。其中位于7号染色体上的显著关联信号是控制α-生育酚含量的主效位点,可在2年环境中被检测到,表型变异解释率为9.83%。对该位点候选基因进行筛选,获得一个编码myb转录因子的基因Glyma.07G054000,可能是这个位点的效应基因。另外,在12号染色体上得到2个编码γ-生育酚甲基转移酶的基因Glyma.12G014200和Glyma.12G014300,有可能是影响Ve含量的重要基因。本研究结果有助于解析大豆籽粒Ve含量的遗传基础及其调控机制,为大豆品质遗传改良奠定了基础。

共封装硒肽和VE微胶囊制备及其理化特性

通过乳化-冷冻干燥联合技术构建微胶囊体系,以实现对具有不同极性的物质(亲水性硒肽和亲脂性VE)的稳态化共封装。以包埋率作为参考,通过单因素试验考察壁材浓度、硒肽和VE含量等工艺参数对包埋效果的影响。傅里叶变换红外光谱和扫描电子显微镜图像表明微胶囊能够有效封装硒肽和VE,并且具有较好的水分散性,复溶后仍保持双重乳液结构。热稳定性分析和2,2’-联氮双(3-乙基苯并噻唑啉-6-磺酸)阳离子自由基清除实验结果证实,相比于硒肽粉末,微胶囊具有更高的热稳定性和抗氧化活性。电子鼻分析结果进一步证实微胶囊体系对硒肽自身异味具有较好的遮掩效果。体外模拟消化实验表明,微胶囊封装提高了硒肽在模拟胃液中的稳定性,并且硒肽在模拟肠液具有更低的保留率,能够被有效释放。相关研究结论将为富硒功能性食品营养补充剂的开发提供理论依据。

采用Karhunen-Loève分解计算堤坝沉降区间场

大坝的建造以及运行过程中受多种内外部多因素耦合作用,其沉降分析是复杂、非线性问题,采用非概率区间方法构造大坝沉降区间有利于定量描述多源不确定信息,使计算更加吻合实际情况。本文将基于Karhunen-Loève分解的区间场有限元方法由线弹性模型扩展至邓肯-张模型中,通过引入平方指数形式的空间依赖函数描述切线模量的空间变异性。采用以Legendre多项式为基函数的Galerkin方法计算模量变化区域的特征值与特征函数。在区间有限元的框架下,编写非线性区间本构模型Abaqus用户子程序UMAT,结合Python脚本计算大坝沉降针对于模量参数变化的响应区间,并与传统顶点集区间方法进行对比。工程实例分析表明,所提方法可以有效计算大坝沉降区间,所得到的沉降区间能涵盖顶点集区间,且有限元计算次数由指数级减少为多项式级。本文方法可以进一步扩展至大坝长期变形区间计算问题。

Research trends on artificial intelligence and endoscopy in digestive diseases: A bibliometric analysis from 1990 to 2022

BACKGROUND Recently,artificial intelligence(AI)has been widely used in gastrointestinal endoscopy examinations.AIM To comprehensively evaluate the application of AI-assisted endoscopy in detecting different digestive diseases using bibliometric analysis.METHODS Relevant publications from the Web of Science published from 1990 to 2022 were extracted using a combination of the search terms“AI”and“endoscopy”.The following information was recorded from the included publications:Title,author,institution,country,endoscopy type,disease type,performance of AI,publication,citation,journal and H-index.RESULTS A total of 446 studies were included.The number of articles reached its peak in 2021,and the annual citation numbers increased after 2006.China,the United States and Japan were dominant countries in this field,accounting for 28.7%,16.8%,and 15.7%of publications,respectively.The Tada Tomohiro Institute of Gastroenterology and Proctology was the most influential institution.“Cancer”and“polyps”were the hotspots in this field.Colorectal polyps were the most concerning and researched disease,followed by gastric cancer and gastrointestinal bleeding.Conventional endoscopy was the most common type of examination.The accuracy of AI in detecting Barrett’s esophagus,colorectal polyps and gastric cancer from 2018 to 2022 is 87.6%,93.7%and 88.3%,respectively.The detection rates of adenoma and gastrointestinal bleeding from 2018 to 2022 are 31.3%and 96.2%,respectively.CONCLUSION AI could improve the detection rate of digestive tract diseases and a convolutional neural network-based diagnosis program for endoscopic images shows promising results.

Capsule endoscopy and panendoscopy:A journey to the future of gastrointestinal endoscopy

In 2000,the small bowel capsule revolutionized the management of patients with small bowel disorders.Currently,the technological development achieved by the new models of double-headed endoscopic capsules,as miniaturized devices to evaluate the small bowel and colon[pan-intestinal capsule endoscopy(PCE)],makes this non-invasive procedure a disruptive concept for the management of patients with digestive disorders.This technology is expected to identify which patients will require conventional invasive endoscopic procedures(colonoscopy or balloon-assisted enteroscopy),based on the lesions detected by the capsule,i.e.,those with an indication for biopsies or endoscopic treatment.The use of PCE in patients with inflammatory bowel diseases,namely Crohn’s disease,as well as in patients with iron deficiency anaemia and/or overt gastrointestinal(GI)bleeding,after a non-diagnostic upper endoscopy(esophagogastroduodenoscopy),enables an effective,safe and comfortable way to identify patients with relevant lesions,who should undergo subsequent invasive endoscopic procedures.The recent development of magnetically controlled capsule endoscopy to evaluate the upper GI tract,is a further step towards the possibility of an entirely non-invasive assessment of all the segments of the digestive tract,from mouth-to-anus,meeting the expectations of the early developers of capsule endoscopy.

T1 colorectal cancer management in the era of minimally invasive endoscopic resection

T1 colorectal cancer(CRC),defined by tumor invasion confined to the submucosa,has historically been managed by surgery.Improved understanding of recurrence and lymph node metastases risk,coupled with advances in endoscopic resection techniques,have led to an increasing capacity for organ-sparing local excision.Minimally invasive management of T1 CRC begins with optical evaluation of the lesion to diagnose invasive disease and quantify depth of invasion,which informs therapeutic decision making.Modality selection between various available endoscopic resection techniques depends upon lesion characteristics,technique risk-benefit profiles,and location-specific implications.Following endoscopic resection,established histopathology features determine the risk of recurrence and subsequent management including surveillance or adjuvant surgical excision.The management of non-operative candidates deviates from conventional recommendations with emerging treatment strategies in select populations.

Therapeutic pediatric upper endoscopy: a retrospective report from a low-volume center

Background:Pediatric endoscopy has become an essential diagnostic and therapeutic tool for a range of gastrointestinal conditions in children,according to published guidelines.This study aimed to assess the indications,outcomes,and complications of therapeutic endoscopy in children at King Abdullah University Hospital(KAUH)in Jordan.Methods:This study conducted a retrospective chart review of therapeutic endoscopic procedures,including esophageal dilation,variceal and non-variceal hemostasis,foreign body retrieval,and percutaneous endoscopic gastrostomy(PEG)Tube insertion,performed between January 2014 and December 2020 at the Gastrointestinal Endoscopy Unit(a mixed adult and pediatric unit)at KAUH.Demographic data,indications for intervention,comorbidities,procedural outcomes,postprocedural treatment,complications,readmission,and patient follow-up data were extracted from the patient's medical records.Results:During the study period,185 patients underwent 260 therapeutic endoscopic procedures.110(60%)of the patients were boys.The average age of the patients was 81.8±51.46(standard deviation)months.Foreign body retrieval was the most common procedure,with accidental ingestion being the primary cause and coins being the most commonly impacted foreign body.Followed by esophageal dilatation and PEG tube insertion.Complications were mild and rare.Conclusion:The success rates and post-procedural complications of pediatric endoscopy procedures are similar between low-and high-volume hospitals worldwide,and procedural volume is not the only factor contributing to procedural outcomes and complication rates.

Advancements in hemostatic strategies for managing upper gastrointestinal bleeding: A comprehensive review

Upper gastrointestinal(GI)hemorrhage presents a substantial clinical challenge.Initial management typically involves resuscitation and endoscopy within 24 h,although the benefit of very early endoscopy(<12 h)for high-risk patients is debated.Treatment goals include stopping acute bleeding,preventing rebleeding,and using a multimodal approach encompassing endoscopic,pharmacological,angiographic,and surgical methods.Pharmacological agents such as vasopressin,prostaglandins,and proton pump inhibitors are effective,but the increase in antithrombotic use has increased GI bleeding morbidity.Endoscopic hemostasis,particularly for nonvariceal bleeding,employs techniques such as electrocoagu-lation and heater probes,with concerns over tissue injury from monopolar electrocoagulation.Novel methods such as Hemospray and Endoclot show promise in creating mechanical tamponades but have limitations.Currently,the first-line therapy includes thermal probes and hemoclips,with over-the-scope clips emerging for larger ulcer bleeding.The gold probe,combining bipolar electrocoagulation and injection,offers targeted coagulation but has faced device-related issues.Future advancements involve combining techniques and improving endoscopic imaging,with studies exploring combined approaches showing promise.Ongoing research is crucial for developing standardized and effective hemorrhage management strategies.

基于QFD/TRIZ/VE的竹木产品成本控制创新设计研究

【目的】该文撰写的主要目的是解决竹木产品质量不达标、种类同质化、价格不合理等问题,在设计阶段实现竹木产品创新设计以及成本的事前控制。【方法】创新集成质量功能配置理论(QFD)、发明问题解决理论(TRIZ)以及价值工程理论(VE)的面向成本控制的竹木产品设计流程。【结果】构建QFD产品质量屋,将用户需求和影响成本因素转化为产品技术特性;运用TRIZ理论将负相关问题转化为标准问题并解决;结合VE理论,完成方案优化及成本评价,输出儿童竹木玩具设计方案。【结论】通过QFD、TRIZ、VE的集成应用具有一定的可行性和有效性,能够有效提高设计效率,完成竹木产品的创新设计并实现竹木产品成本的事前控制。

Endohepatology:Arrival at the frontier of interventional endosonography

Endohepatology describes the emerging field where diagnostic and therapeutic endoscopic ultrasound(EUS)are used for the diagnosis and management of liver disease and its sequelae.In this editorial we comment on the article by Gadour et al.The spectrum of EUS-guided procedures includes liver parenchymal and lesional biopsy,abscess drainage,treatment of focal liver lesions,diagnosis of portal hypertension and management of gastric varices.The data suggest that the application of EUS to hepatology is technically feasible and safe,heralding the arrival at a new frontier for EUS.More data,specifically randomised trials comparing EUS to interventional radiology techniques,and continued partnership between endoscopy and hepatology are required to see this field establish itself outside expert tertiary centres.

Esophageal intramural pseudodiverticulosis

Esophageal intramural pseudodiverticulosis(EIPD)is a disease of unknown pathogenesis characterized by usually systemic,cystic dilatation of the excretory ducts of esophageal submucosal glands.In this article,I review the epidemiology,clinical manifestations,endoscopic findings,esophagographic findings,and histopathology of EIPD.I also discuss the etiology and possible pathogenesis of EIPD based on my experiences with this disease and a review of the literature.EIPD usually presents with dysphagia in middle-aged individuals.It is often complicated with secondary infections,most commonly candidiasis.On esophagography,EIPD is delineated as small,multiple,flask-shaped outward projections within the esophageal wall.In recent years,EIPD has been mainly diagnosed by endoscopic findings of multiple,localized,small mucosal depressions.The orifices of the“pseudodiverticula”periodically open and close,and excrete mucus onto the mucosal surface.On histopathological examination,the luminal surface of dilated ducts in EIPD is covered by multilayered,hyperplastic epithelial cells,but myoepithelial cells in the glandular acini are well preserved.Treatment of EIPD is usually symptomatic therapy,and prevention of the infectious complications is important.The etiology and pathogenesis of EIPD are largely unknown,but functional abnormalities of autonomic nerve fibers innervating the esophageal glands likely play an important role,since the structures of the glands are basically preserved in this disease.

Application Research of PETD Combined with MRI Nerve Root Water Imaging in the Minimally Invasive Treatment of LDH

Objective: This study aims to evaluate the safety and efficacy of PETD combined with nerve root water imaging of MRI for the treatment of lumbar disc herniation. Methods: A retrospective review was performed on 62 patients with lumbar disc herniation from March 2019 to March 2021. The study included an experimental group of 30 patients and a control group of 32 patients. The experimental group underwent PETD combined with nerve root water imaging of MRI, while the control group received traditional PETD treatment. The visual analogue scoring method (VAS score), and JOA lumbar spine function score before and after surgery were compared between the two groups, and efficacy was assessed and compared using the MacNab score. Results: The mean operation time was significantly reduced in the experimental group (56.43 &#177;10.40 minutes) compared to the control group (65.69 &#177;14.12 minutes). The VAS score was compared between the two groups with preoperative (p = 0.624), one month after surgery (p = 0.325), three months after surgery (p = 0.676), one year after surgery (p = 0.341);The JOA score was compared between the two groups with preoperative (p = 0.961), one month after the surgery (p = 0.266), three months after surgery (p = 0.185), one year after surgery (p = 0.870), they were no significant statistical difference;The efficacy evaluation of the last follow-up Macnab showed that all the 30 patients in the experimental group were excellent, 31 of 32 patients in the control group were excellent, 1 case was good;There was no statistical difference in the comparison between the two groups (p > 0.05). Conclusion: The study concludes that the combined approach of PETD with nerve root water imaging of MRI is a safe, effective, and more efficient alternative to conventional PETD for treating lumbar disc herniation.

Effect of navigation endoscopy combined with threedimensional printing technology in the treatment of orbital blowout fractures

●AIM:To explore the combined application of surgical navigation nasal endoscopy(NNE)and three-dimensional printing technology(3DPT)for the adjunctive treatment of orbital blowout fractures(OBF).●METHODS:Retrospective analysis was conducted on the data of patients with OBF who underwent surgical treatment at the Affiliated Eye Hospital of Nanchang University between July 2012 and November 2022.The control group consisted of patients who received traditional surgical treatment(n=43),while the new surgical group(n=52)consisted of patients who received NNE with 3DPT.The difference in therapeutic effects between the two groups was evaluated by comparing the duration of the operation,best corrected visual acuity(BCVA),enophthalmos difference,recovery rate of eye movement disorder,recovery rate of diplopia,and incidence of postoperative complications.●RESULTS:The study included 95 cases(95 eyes),with 63 men and 32 women.The patients’age ranged from 5 to 67y(35.21±15.75y).The new surgical group and the control group exhibited no statistically significant differences in the duration of the operation,BCVA and enophthalmos difference.The recovery rates of diplopia in the new surgical group were significantly higher than those in the control group at 1mo[OR=0.03,95%CI(0.01–0.15),P<0.0000]and 3mo[OR=0.11,95%CI(0.03–0.36),P<0.0000]postoperation.Additionally,the recovery rates of eye movement disorders at 1 and 3mo after surgery were OR=0.08,95%CI(0.03–0.24),P<0.0000;and OR=0.01,95%CI(0.00–0.18),P<0.0000.The incidence of postoperative complications was lower in the new surgical group compared to the control group[OR=4.86,95%CI(0.95–24.78),P<0.05].●CONCLUSION:The combination of NNE and 3DPT can shorten the recovery time of diplopia and eye movement disorder in patients with OBF.

Tennis ball cord combined with endoscopy for giant gastric phytobezoar:A case report

BACKGROUND Due to the specificity of Chinese food types,gastric phytobezoars are relatively common in China.Most gastric phytobezoars can be removed by chemical enzyme lysis and endoscopic fragmentation,but the treatment for large phytobezoars is limited,and surgical procedures are often required for this difficult problem.CASE SUMMARY For giant gastric phytobezoars that cannot be dissolved and fragmented by conventional treatment,we have invented a new lithotripsy technique(tennis ball cord combined with endoscopy)for these phytobezoars.This non-interventional treatment was successful in a patient whose abdominal pain was immediately relieved,and the gastroscope-induced ulcer healed well 3 d after lithotripsy.The patient was followed-up for 8 wk postoperatively and showed no discomfort such as abdominal pain.CONCLUSION The combination of tennis ball cord and endoscopy for the treatment of giant gastric phytobezoars is feasible and showed high safety and effectiveness,and can be widely applied in hospitals of all sizes.