BACKGROUND Painless gastroenteroscopy is a widely developed diagnostic and treatment technology in clinical practice.It is of great significance in the clinical diagnosis,treatment,follow-up review and other aspects o...BACKGROUND Painless gastroenteroscopy is a widely developed diagnostic and treatment technology in clinical practice.It is of great significance in the clinical diagnosis,treatment,follow-up review and other aspects of gastric cancer patients.The application of anesthesia techniques during manipulation can be effective in reducing patient fear and discomfort.In clinical work,the adverse drug reactions of anesthesia regimens and the risk of serious adverse drug reactions are increased with the increase in propofol application dose application dose;the application of opioid drugs often causes gastrointestinal reactions,such as nausea,vomiting and delayed gastrointestinal function recovery,after examination.These adverse effects can seriously affect the quality of life of patients.AIM To observe the effect of modified ShengYangYiwei decoction on gastrointestinal function,related complications and immune function in patients with gastric cancer during and after painless gastroscopy.METHODS A total of 106 patients with gastric cancer,who were selected from January 2022 to September 2022 in Xiamen Traditional Chinese Medicine Hospital for painless gastroscopy,were randomly divided into a treatment group(n=56)and a control group(n=50).Before the examination,all patients fasted for 8 h,provided their health education,and confirmed if there were contraindications to anesthesia and gastroscopy.During the examination,the patients were placed in the left decubitus position,the patients were given oxygen through a nasal catheter(6 L/min),the welling needle was opened for the venous channel,and a multifunction detector was connected for monitoring electrocardiogram,oxygen saturation,blood pressure,etc.Naporphl and propofol propofol protocols were used for routine anesthesia.Before anesthesia administration,the patients underwent several deep breathing exercises,received intravenous nalbuphine[0.nalbuphine(0.025 mg/kg)],followed by intravenous propofol[1.propofol(1.5 mg/kg)]until the palpebral reflex disappeared,and after no response,gastroscopy was performed.If palpebral reflex disappeared,and after no response,gastroscopy was performed.If any patient developed movement,frowning,or hemodynamic changes during the operation(heart rate changes during the operation(heart rate increased to>20 beats/min,systolic blood pressure increased to>20%of the base value),additional propofol[0.propofol(0.5 mg/kg)]was added until the patient was sedated again.The patients in the treatment group began to take the preventive intervention of Modified ShengYangYiwei decoction one week before the examination,while the patients in the control group received routine gastrointestinal endoscopy.The patients in the two groups were examined by conventional painless gastroscopy,and the characteristics of the painless gastroscopies of the patients in the two groups were recorded and compared.These characteristics included the total dosage of propofol during the examination,the incidence of complications during the operation,the time of patients'awakening,the time of independent activities,and the gastrointestinal function of the patients after examination,such as the incidence of reactions such as malignant vomiting,abdominal distension and abdominal pain,as well as the differences in the levels of various immunological indicators and inflammatory factors before anesthesia induction(T0),after conscious extubation(T1)and 24 h after surgery(T2).RESULTS There was no difference in the patients’general information,American Society of Anesthesiologist classification or operation time between the two groups before treatment.In terms of painless gastroscopy,the total dosage of propofol in the treatment group was lower than that in the control group(P<0.05),and the time of awakening and autonomous activity was significantly faster than that in the control group(P<0.05).During the examination,the incidence of hypoxemia,hypotension and hiccups in the treatment group was significantly lower than that in the control group(P<0.01).In terms of gastrointestinal function,the incidences of nausea,vomiting,abdominal distension and abdominal pain in the treatment group after examination were significantly lower than those in the control group(P<0.01).In terms of immune function,in both groups,the number of CD4+and CD8+cells decreased significantly(P<0.05),and the number of natural killer cells increased significantly(P<0.05)at T1 and T2,compared with T0.The number of CD4+and CD8+cells in the treatment group at the T1 and T2 time points was higher than that in the control group(P<0.05),while the number of natural killer cells was lower than that in the control group(P<0.05).In terms of inflammatory factors,compared with T0,the levels of interleukin(IL)-6 and tumor necrosis factor-alpha in patients in the two groups at T1 and T2 increased significantly and then decreased(P<0.05).The level of IL-6 at T1 and T2 in the treatment group was lower than that in the control group(P<0.05).CONCLUSION The preoperative use of modified ShengYangYiwei decoction can optimize the anesthesia program during painless gastroscopy,improve the gastrointestinal function of patients after the operation,reduce the occurrence of examination-related complications.展开更多
BACKGROUND Gastric cancer(GC)is a malignant tumor with a high incidence and mortality rate worldwide for which acute bleeding is a common clinical complication.Gastro-scopic hemostasis is an important method for treat...BACKGROUND Gastric cancer(GC)is a malignant tumor with a high incidence and mortality rate worldwide for which acute bleeding is a common clinical complication.Gastro-scopic hemostasis is an important method for treating acute bleeding in GC;however,its efficacy and safety remain controversial.AIM To systematically analyze the efficacy and safety of gastroscopic hemostasis for the treatment of acute gastric hemorrhage.METHODS The PUBMED,Web of Science,Wiley Library,EMBASE,Wanfang,CNKI,and VIP databases were searched for studies related to gastroscopic hemostatic treatment for acute GC published through February 20,2023.The literature was screened according to the inclusion and exclusion criteria,data were extracted,and lite-rature quality was evaluated.The meta-analysis was performed using RevMan software(version 5.3),while Begg’s test for publication bias was performed using Stata 13.0 software.RESULTS Six randomized controlled trials and two retrospective analyses were retrieved.Five studies had a low,two had an uncertain,and one had a high risk of bias.Compared with the control group,the hemostatic rate of gastroscopic hemostasis was increased[relative risk(RR)=1.24;95%confidence interval(CI):1.08 to 1.43;P=0.003];the rate of rebleeding(RR=0.27;95%CI:0.09 to 0.80;P=0.02),rate of surgery transfer(RR=0.16;95%CI:0.06 to 0.43;P=0.0003),serum C-reactive protein level[mean difference(MD)=-5.16;95%CI:-6.11 to 4.21;P<0.00001],interleukin-6 level(MD=-6.37;95%CI:-10.33 to-2.42;P=0.002),and tumor necrosis factor-αlevel(MD=-2.29;95%CI:-4.06 to-0.52;P=0.01)were decreased;and the quality of life improvement rate was increased(RR=1.95;95%C I=1.41-2.71;P<0.0001).Begg’s test revealed no significant publication bias.CONCLUSION The efficacy and safety of endoscopic hemostasis were higher than those of the control group,suggesting that it is an effective treatment for acute GC hemorrhage.展开更多
BACKGROUND Pancreatic neuroendocrine neoplasms(PNENs)are a rare group of neoplasms originating from the islets of the Langerhans.Portal vein tumor thrombosis has been reported in 33%of patients with PNENs.While the hi...BACKGROUND Pancreatic neuroendocrine neoplasms(PNENs)are a rare group of neoplasms originating from the islets of the Langerhans.Portal vein tumor thrombosis has been reported in 33%of patients with PNENs.While the histopathological diagnosis of PNENs is usually based on percutaneous biopsy or endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA),these approaches may be impeded by gastric varices,poor access windows,or anatomically contiguous critical structures.Obtaining a pathological diagnosis using a gastroscope biopsy forceps via percutaneous transhepatic intravascular pathway is an innovative method that has rarely been reported.CASE SUMMARY A 72-year-old man was referred to our hospital for abdominal pain and melena.Abdominal contrast-enhanced magnetic resonance imaging revealed a wellenhanced tumor(size:2.4 cm×1.2 cm×1.2 cm)in the pancreatic tail with portal vein invasion.Traditional pathological diagnosis via EUS-FNA was not possible because of diffuse gastric varices.We performed a percutaneous transportal biopsy of the portal vein tumor thrombus using a gastroscope biopsy forceps.Histopathologic examination revealed a pancreatic neuroendocrine neoplasm(G2)with somatostatin receptors 2(+),allowing systemic treatment.CONCLUSION Intravascular biopsy using gastroscope biopsy forceps appears to be a safe and effective method for obtaining a histopathological diagnosis.Although welldesigned clinic trials are required to obtain more definitive evidence,this procedure may help improve the diagnosis of portal vein thrombosis and related diseases.展开更多
Objective:To explore the value of Helicobacter pylori antibody (Hp-IgG) and serum pepsinogen (PG) combined with gastroscopy for screening early gastric cancer and precancerous lesions in high-risk groups, so as to pro...Objective:To explore the value of Helicobacter pylori antibody (Hp-IgG) and serum pepsinogen (PG) combined with gastroscopy for screening early gastric cancer and precancerous lesions in high-risk groups, so as to provide references for early clinical prevention and diagnosis.Methods: A retrospective analysis of our hospital from December 2014 to December 2017 were elderly patients with gastric cancer 304 cases, selected admitted 122 cases of elderly patients with gastric precancerous lesion (divided into superficial gastritis group, 70 cases of chronic atrophic gastritis group 52 cases) and 156 cases to the hospital in healthy volunteers as the control group. The status and the positive rate of Helicobacter pylori 13C urea breath test and compared two groups of patients with infection;using enzyme-linked immunosorbent assay of serum pepsinogen I (PG I), II (PG II) and pepsin Hp-IgG quantitative and qualitative diagnosis of individual and combined diagnostic efficiency and the comparison of three kinds of index.Results: The four groups were compared, the serum PG level of I from high to low were superficial gastritis group, normal control group, atrophic gastritis group and gastric cancer group, the differences were statistically significant;serum PG II levels from high to low in gastric cancer group and superficial gastritis group. Atrophic gastritis group, normal control group, the differences were statistically significant. Compared with the three groups, the positive rate of Hp-IgG was 90.7% in the gastric cancer group, 45.6% in the superficial gastritis group, 52.5% in the atrophic gastritis group, and the gastric cancer group was higher than that in the precancerous lesion group, but there was no difference between the precancerous lesions group. In terms of diagnostic efficacy, the specificity and sensitivity of Helicobacter pylori combined with pepsinogen were higher than those of the single diagnosis. Conclusion: Hp-IgG and PG combined with gastroscopy in screening high-risk gastric cancer and its precancerous lesions are of high specificity, high sensitivity and can be popularized in clinic.展开更多
A patient with stent embedding after placement of an esophageal stent for an esophagobronchial fistula was treated with an ST-E plastic tube inserted into the esophagus to the upper end of the stent using gastroscopy....A patient with stent embedding after placement of an esophageal stent for an esophagobronchial fistula was treated with an ST-E plastic tube inserted into the esophagus to the upper end of the stent using gastroscopy.The gastroscope was guided into the esophagus through the ST-E tube,and an alligator forceps was inserted into the esophagus through the ST-E tube alongside the gastroscope.Under gastroscopy,the stent wire was grasped with the forceps and pulled into the ST-E tube.When resistance was met during withdrawal,the gastroscope was guided further to the esophageal section where the stent was embedded.Biopsy forceps were guided through a biopsy hole in the gastroscope to the embedded stent to remove silicone membranes and connection threads linking the Z-shaped wire mesh.While the lower section of the Z-shaped stent was fixed by the biopsy forceps,the alligator forceps were used to pull the upper section of the metal wire until the Z-shaped metal loops elongated.The wire mesh of the stent was then removed in stages through the ST-E tube.Care was taken to avoid bleeding and perforation.Under the assistance of an ST-E plastic tube,an embedded esophageal metal stent was successfully removed with no bleeding or perforation.The patient experienced an uneventful recovery after surgery.Plastic tube-assisted gastroscopic removal of embedded metal stents can be minimally invasive,safe,and effective.展开更多
Twenty-two cases of special types of early gastric cancer were by endoscopy with biopsy in our hospital.There cases were cancers simulating gastritis, 6 cases were ulcers with malignant change,2 cases of gastric angle...Twenty-two cases of special types of early gastric cancer were by endoscopy with biopsy in our hospital.There cases were cancers simulating gastritis, 6 cases were ulcers with malignant change,2 cases of gastric angle ulcer in scar stage with malignant change, 11 case of advanced gastric cancer.The characteristics of these lesions were described and analyzed in oredr to study further the occurvence and development of he gastric cancer and to recognize some special types of early gastric cancer and early diagnosis of the disease.展开更多
Objective To evaluate the economy of detecting gastric cancer by electronic gastroscope in Chinese natural population of different ages and genders.Methods A Markov model was constructed for the population,including b...Objective To evaluate the economy of detecting gastric cancer by electronic gastroscope in Chinese natural population of different ages and genders.Methods A Markov model was constructed for the population,including both men and women of different ages.The model cycle was one year and the simulation time was 60 years.The cost-effectiveness of electronic gastroscopy in detecting gastric cancer of general population in China was analyzed from the perspective of the whole society,and the stability of the results was verified by sensitivity analysis.Results and Conclusion For the general population,the incremental cost-effectiveness ratio(ICER)of gastric cancer screening from the age of 50 is 50143 yuan/QALY(quality-adjusted life-year),which is less than two times of per capita gross domestic product(GDP)compared with the screening from the age of 55.For men who start gastric cancer screening at the age of 50,the ICER is 38525 yuan/QALY,which is less than two times of per capita GDP,and it is economical.For women who start the screening from the age of 55,the ICER is 47814 yuan/QALY,which is less than two times of per capita GDP,so it is economical.The results of sensitivity analysis are consistent with the conclusions of basic analysis,and the results of basic analysis are stable.For the general population,it is more economical to start gastric cancer screening from the age of 50,while for men and women,it is more economical to start gastric cancer screening from the age of 50 and 55,respectively.展开更多
Objective:To explore and analyze the diagnostic value of gastroscopic biopsy and surgical pathology in improving the diagnostic accuracy of gastric cancer.Methods:From May 2019 to June 2020,80 patients with gastric ca...Objective:To explore and analyze the diagnostic value of gastroscopic biopsy and surgical pathology in improving the diagnostic accuracy of gastric cancer.Methods:From May 2019 to June 2020,80 patients with gastric cancer treated in Shuyang Xiehe Hospital were selected and divided into two groups,a control group and a study group,with 40 cases in each group,based on the examination method individually selected by the patients.The patients in the control group were investigated via gastroscopy,while those in the study group were investigated by surgical pathology.The diagnostic values of the two methods were compared and analyzed.Results:The diagnostic accuracy of patients in the study group was 100%,which was higher than that of the control group.The tissue type,lesion morphology,and cancer differentiation of the study group were better than those of the control group.There was significant difference between the two methods(P<0.05).Conclusion:Surgical and pathological examination can improve the diagnostic accuracy of gastric cancer,comprehensively analyze the patient’s condition,and provide corresponding theoretical basis for follow-up treatment,so that patients can obtain more active and effective treatment,reduce pain,and improve their quality of life.展开更多
基金Supported by Xiamen Municipal Science and Technology Bureau Municipal Medical and Health Guidance Project,No.3502Z20224ZD1169Joint project of Natural Science Foundation of Xiamen Municipal Bureau of Science and Technology,No.3502Z20227368The Sixth Batch of Chinese Medicine Reserve Talent Training Project in Xiamen(Xiamen Municipal Health Commission Traditional Chinese Medicine),No.[2022]No.136.
文摘BACKGROUND Painless gastroenteroscopy is a widely developed diagnostic and treatment technology in clinical practice.It is of great significance in the clinical diagnosis,treatment,follow-up review and other aspects of gastric cancer patients.The application of anesthesia techniques during manipulation can be effective in reducing patient fear and discomfort.In clinical work,the adverse drug reactions of anesthesia regimens and the risk of serious adverse drug reactions are increased with the increase in propofol application dose application dose;the application of opioid drugs often causes gastrointestinal reactions,such as nausea,vomiting and delayed gastrointestinal function recovery,after examination.These adverse effects can seriously affect the quality of life of patients.AIM To observe the effect of modified ShengYangYiwei decoction on gastrointestinal function,related complications and immune function in patients with gastric cancer during and after painless gastroscopy.METHODS A total of 106 patients with gastric cancer,who were selected from January 2022 to September 2022 in Xiamen Traditional Chinese Medicine Hospital for painless gastroscopy,were randomly divided into a treatment group(n=56)and a control group(n=50).Before the examination,all patients fasted for 8 h,provided their health education,and confirmed if there were contraindications to anesthesia and gastroscopy.During the examination,the patients were placed in the left decubitus position,the patients were given oxygen through a nasal catheter(6 L/min),the welling needle was opened for the venous channel,and a multifunction detector was connected for monitoring electrocardiogram,oxygen saturation,blood pressure,etc.Naporphl and propofol propofol protocols were used for routine anesthesia.Before anesthesia administration,the patients underwent several deep breathing exercises,received intravenous nalbuphine[0.nalbuphine(0.025 mg/kg)],followed by intravenous propofol[1.propofol(1.5 mg/kg)]until the palpebral reflex disappeared,and after no response,gastroscopy was performed.If palpebral reflex disappeared,and after no response,gastroscopy was performed.If any patient developed movement,frowning,or hemodynamic changes during the operation(heart rate changes during the operation(heart rate increased to>20 beats/min,systolic blood pressure increased to>20%of the base value),additional propofol[0.propofol(0.5 mg/kg)]was added until the patient was sedated again.The patients in the treatment group began to take the preventive intervention of Modified ShengYangYiwei decoction one week before the examination,while the patients in the control group received routine gastrointestinal endoscopy.The patients in the two groups were examined by conventional painless gastroscopy,and the characteristics of the painless gastroscopies of the patients in the two groups were recorded and compared.These characteristics included the total dosage of propofol during the examination,the incidence of complications during the operation,the time of patients'awakening,the time of independent activities,and the gastrointestinal function of the patients after examination,such as the incidence of reactions such as malignant vomiting,abdominal distension and abdominal pain,as well as the differences in the levels of various immunological indicators and inflammatory factors before anesthesia induction(T0),after conscious extubation(T1)and 24 h after surgery(T2).RESULTS There was no difference in the patients’general information,American Society of Anesthesiologist classification or operation time between the two groups before treatment.In terms of painless gastroscopy,the total dosage of propofol in the treatment group was lower than that in the control group(P<0.05),and the time of awakening and autonomous activity was significantly faster than that in the control group(P<0.05).During the examination,the incidence of hypoxemia,hypotension and hiccups in the treatment group was significantly lower than that in the control group(P<0.01).In terms of gastrointestinal function,the incidences of nausea,vomiting,abdominal distension and abdominal pain in the treatment group after examination were significantly lower than those in the control group(P<0.01).In terms of immune function,in both groups,the number of CD4+and CD8+cells decreased significantly(P<0.05),and the number of natural killer cells increased significantly(P<0.05)at T1 and T2,compared with T0.The number of CD4+and CD8+cells in the treatment group at the T1 and T2 time points was higher than that in the control group(P<0.05),while the number of natural killer cells was lower than that in the control group(P<0.05).In terms of inflammatory factors,compared with T0,the levels of interleukin(IL)-6 and tumor necrosis factor-alpha in patients in the two groups at T1 and T2 increased significantly and then decreased(P<0.05).The level of IL-6 at T1 and T2 in the treatment group was lower than that in the control group(P<0.05).CONCLUSION The preoperative use of modified ShengYangYiwei decoction can optimize the anesthesia program during painless gastroscopy,improve the gastrointestinal function of patients after the operation,reduce the occurrence of examination-related complications.
文摘BACKGROUND Gastric cancer(GC)is a malignant tumor with a high incidence and mortality rate worldwide for which acute bleeding is a common clinical complication.Gastro-scopic hemostasis is an important method for treating acute bleeding in GC;however,its efficacy and safety remain controversial.AIM To systematically analyze the efficacy and safety of gastroscopic hemostasis for the treatment of acute gastric hemorrhage.METHODS The PUBMED,Web of Science,Wiley Library,EMBASE,Wanfang,CNKI,and VIP databases were searched for studies related to gastroscopic hemostatic treatment for acute GC published through February 20,2023.The literature was screened according to the inclusion and exclusion criteria,data were extracted,and lite-rature quality was evaluated.The meta-analysis was performed using RevMan software(version 5.3),while Begg’s test for publication bias was performed using Stata 13.0 software.RESULTS Six randomized controlled trials and two retrospective analyses were retrieved.Five studies had a low,two had an uncertain,and one had a high risk of bias.Compared with the control group,the hemostatic rate of gastroscopic hemostasis was increased[relative risk(RR)=1.24;95%confidence interval(CI):1.08 to 1.43;P=0.003];the rate of rebleeding(RR=0.27;95%CI:0.09 to 0.80;P=0.02),rate of surgery transfer(RR=0.16;95%CI:0.06 to 0.43;P=0.0003),serum C-reactive protein level[mean difference(MD)=-5.16;95%CI:-6.11 to 4.21;P<0.00001],interleukin-6 level(MD=-6.37;95%CI:-10.33 to-2.42;P=0.002),and tumor necrosis factor-αlevel(MD=-2.29;95%CI:-4.06 to-0.52;P=0.01)were decreased;and the quality of life improvement rate was increased(RR=1.95;95%C I=1.41-2.71;P<0.0001).Begg’s test revealed no significant publication bias.CONCLUSION The efficacy and safety of endoscopic hemostasis were higher than those of the control group,suggesting that it is an effective treatment for acute GC hemorrhage.
基金the National Natural Science Foundation of China,No.82000566Natural Science Foundation of Shandong Province,No.ZR2020QH036 and No.ZR2022MH010.
文摘BACKGROUND Pancreatic neuroendocrine neoplasms(PNENs)are a rare group of neoplasms originating from the islets of the Langerhans.Portal vein tumor thrombosis has been reported in 33%of patients with PNENs.While the histopathological diagnosis of PNENs is usually based on percutaneous biopsy or endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA),these approaches may be impeded by gastric varices,poor access windows,or anatomically contiguous critical structures.Obtaining a pathological diagnosis using a gastroscope biopsy forceps via percutaneous transhepatic intravascular pathway is an innovative method that has rarely been reported.CASE SUMMARY A 72-year-old man was referred to our hospital for abdominal pain and melena.Abdominal contrast-enhanced magnetic resonance imaging revealed a wellenhanced tumor(size:2.4 cm×1.2 cm×1.2 cm)in the pancreatic tail with portal vein invasion.Traditional pathological diagnosis via EUS-FNA was not possible because of diffuse gastric varices.We performed a percutaneous transportal biopsy of the portal vein tumor thrombus using a gastroscope biopsy forceps.Histopathologic examination revealed a pancreatic neuroendocrine neoplasm(G2)with somatostatin receptors 2(+),allowing systemic treatment.CONCLUSION Intravascular biopsy using gastroscope biopsy forceps appears to be a safe and effective method for obtaining a histopathological diagnosis.Although welldesigned clinic trials are required to obtain more definitive evidence,this procedure may help improve the diagnosis of portal vein thrombosis and related diseases.
基金National Natural Science Foundation of China No.30370747.
文摘Objective:To explore the value of Helicobacter pylori antibody (Hp-IgG) and serum pepsinogen (PG) combined with gastroscopy for screening early gastric cancer and precancerous lesions in high-risk groups, so as to provide references for early clinical prevention and diagnosis.Methods: A retrospective analysis of our hospital from December 2014 to December 2017 were elderly patients with gastric cancer 304 cases, selected admitted 122 cases of elderly patients with gastric precancerous lesion (divided into superficial gastritis group, 70 cases of chronic atrophic gastritis group 52 cases) and 156 cases to the hospital in healthy volunteers as the control group. The status and the positive rate of Helicobacter pylori 13C urea breath test and compared two groups of patients with infection;using enzyme-linked immunosorbent assay of serum pepsinogen I (PG I), II (PG II) and pepsin Hp-IgG quantitative and qualitative diagnosis of individual and combined diagnostic efficiency and the comparison of three kinds of index.Results: The four groups were compared, the serum PG level of I from high to low were superficial gastritis group, normal control group, atrophic gastritis group and gastric cancer group, the differences were statistically significant;serum PG II levels from high to low in gastric cancer group and superficial gastritis group. Atrophic gastritis group, normal control group, the differences were statistically significant. Compared with the three groups, the positive rate of Hp-IgG was 90.7% in the gastric cancer group, 45.6% in the superficial gastritis group, 52.5% in the atrophic gastritis group, and the gastric cancer group was higher than that in the precancerous lesion group, but there was no difference between the precancerous lesions group. In terms of diagnostic efficacy, the specificity and sensitivity of Helicobacter pylori combined with pepsinogen were higher than those of the single diagnosis. Conclusion: Hp-IgG and PG combined with gastroscopy in screening high-risk gastric cancer and its precancerous lesions are of high specificity, high sensitivity and can be popularized in clinic.
基金Supported by The National Natural Science Foundation,Grant No.81070384
文摘A patient with stent embedding after placement of an esophageal stent for an esophagobronchial fistula was treated with an ST-E plastic tube inserted into the esophagus to the upper end of the stent using gastroscopy.The gastroscope was guided into the esophagus through the ST-E tube,and an alligator forceps was inserted into the esophagus through the ST-E tube alongside the gastroscope.Under gastroscopy,the stent wire was grasped with the forceps and pulled into the ST-E tube.When resistance was met during withdrawal,the gastroscope was guided further to the esophageal section where the stent was embedded.Biopsy forceps were guided through a biopsy hole in the gastroscope to the embedded stent to remove silicone membranes and connection threads linking the Z-shaped wire mesh.While the lower section of the Z-shaped stent was fixed by the biopsy forceps,the alligator forceps were used to pull the upper section of the metal wire until the Z-shaped metal loops elongated.The wire mesh of the stent was then removed in stages through the ST-E tube.Care was taken to avoid bleeding and perforation.Under the assistance of an ST-E plastic tube,an embedded esophageal metal stent was successfully removed with no bleeding or perforation.The patient experienced an uneventful recovery after surgery.Plastic tube-assisted gastroscopic removal of embedded metal stents can be minimally invasive,safe,and effective.
文摘Twenty-two cases of special types of early gastric cancer were by endoscopy with biopsy in our hospital.There cases were cancers simulating gastritis, 6 cases were ulcers with malignant change,2 cases of gastric angle ulcer in scar stage with malignant change, 11 case of advanced gastric cancer.The characteristics of these lesions were described and analyzed in oredr to study further the occurvence and development of he gastric cancer and to recognize some special types of early gastric cancer and early diagnosis of the disease.
文摘Objective To evaluate the economy of detecting gastric cancer by electronic gastroscope in Chinese natural population of different ages and genders.Methods A Markov model was constructed for the population,including both men and women of different ages.The model cycle was one year and the simulation time was 60 years.The cost-effectiveness of electronic gastroscopy in detecting gastric cancer of general population in China was analyzed from the perspective of the whole society,and the stability of the results was verified by sensitivity analysis.Results and Conclusion For the general population,the incremental cost-effectiveness ratio(ICER)of gastric cancer screening from the age of 50 is 50143 yuan/QALY(quality-adjusted life-year),which is less than two times of per capita gross domestic product(GDP)compared with the screening from the age of 55.For men who start gastric cancer screening at the age of 50,the ICER is 38525 yuan/QALY,which is less than two times of per capita GDP,and it is economical.For women who start the screening from the age of 55,the ICER is 47814 yuan/QALY,which is less than two times of per capita GDP,so it is economical.The results of sensitivity analysis are consistent with the conclusions of basic analysis,and the results of basic analysis are stable.For the general population,it is more economical to start gastric cancer screening from the age of 50,while for men and women,it is more economical to start gastric cancer screening from the age of 50 and 55,respectively.
文摘Objective:To explore and analyze the diagnostic value of gastroscopic biopsy and surgical pathology in improving the diagnostic accuracy of gastric cancer.Methods:From May 2019 to June 2020,80 patients with gastric cancer treated in Shuyang Xiehe Hospital were selected and divided into two groups,a control group and a study group,with 40 cases in each group,based on the examination method individually selected by the patients.The patients in the control group were investigated via gastroscopy,while those in the study group were investigated by surgical pathology.The diagnostic values of the two methods were compared and analyzed.Results:The diagnostic accuracy of patients in the study group was 100%,which was higher than that of the control group.The tissue type,lesion morphology,and cancer differentiation of the study group were better than those of the control group.There was significant difference between the two methods(P<0.05).Conclusion:Surgical and pathological examination can improve the diagnostic accuracy of gastric cancer,comprehensively analyze the patient’s condition,and provide corresponding theoretical basis for follow-up treatment,so that patients can obtain more active and effective treatment,reduce pain,and improve their quality of life.