BACKGROUND The incidence of Barrett’s esophagus(BE)in China is lower compared to the Western populations.Hence,studies conducted in the Chinese population has been limited.The current treatment options available for ...BACKGROUND The incidence of Barrett’s esophagus(BE)in China is lower compared to the Western populations.Hence,studies conducted in the Chinese population has been limited.The current treatment options available for BE treatment includes argon plasma coagulation(APC),radiofrequency ablation and cryoablation,all with varying degrees of success.AIM To determine the efficacy and safety of HybridAPC in the treatment of BE.METHODS The study cohort consisted of patients with BE who underwent HybridAPC ablation treatment.These procedures were performed by seven endoscopists from different tertiary hospitals.The duration of the procedure,curative rate,complications and recurrent rate by 1-year follow-up were recorded.RESULTS Eighty individuals were enrolled for treatment from July 2017 to June 2020,comprising of 39 males and 41 females with a median age of 54 years(range,30 to 83 years).The technical success rate of HybridAPC was 100%and the overall curative rate was 98.15%.No severe complications occurred during the operation.BE cases were classified as short-segment BE and long-segment BE.Patients with short-segment BE were all considered cured without complications.Thirty-six patients completed the one-year follow-up without recurrence.Twenty-four percent had mild dysplasia which were all resolved with one post-procedural treatment.The mean duration of the procedure was 10.94±6.52 min.CONCLUSION Treatment of BE with HybridAPC was found to be a simple and quick procedure that is safe and effective during the short-term follow-up,especially in cases of short-segment BE.This technique could be considered as a feasible alternative ablation therapy for BE.展开更多
Radiofrequency ablation(RFA)is very effective for eradication of flat Barrett’s mucosa in dysplastic Barrett’s esophagus after endoscopic resection of raised lesions.However,in a minority of the time,RFA may be inef...Radiofrequency ablation(RFA)is very effective for eradication of flat Barrett’s mucosa in dysplastic Barrett’s esophagus after endoscopic resection of raised lesions.However,in a minority of the time,RFA may be ineffective at eradication of the Barrett’s mucosa.Achieving complete eradication of intestinal metaplasia can be challenging in these patients.This review article focuses on the management of patients with dysplastic Barrett’s esophagus refractory to RFA therapy.Management strategies discussed in this review include optimizing the RFA procedure,optimizing acid suppression(with medical,endoscopic,and surgical management),cryotherapy,hybrid argon plasma coagulation,and EndoRotor resection.展开更多
A submerged internal circulating membrane coagulation reactor （MCR） was used to treat surface water to produce drinking water. Polyaluminum chloride （PAC1） was used as coagulant, and a hydrophilic polyvinylidene f...A submerged internal circulating membrane coagulation reactor （MCR） was used to treat surface water to produce drinking water. Polyaluminum chloride （PAC1） was used as coagulant, and a hydrophilic polyvinylidene fluoride （PVDF） submerged hollow fiber microfiltration membrane was employed. The influences of trans-membrane pressure （TMP）, zeta potential （ZP） of the suspended particles in raw water, and KMnO4 dosing on water flux and the removal of turbidity and organic matter were systematically investigated. Continuous bench-scale experiments showed that the permeate quality of the MCR satisfied the requirement for a centralized water supply, according to the Standards for Drinking Water Quality of China （GB B749-2006）, as evaluated by turbidity （〈1 NTU） and total organic carbon （TOC） （〈5 mE/L） measurements. Besides water flux, the removal of turbidity, TOC and dissolved organic carbon （DOC） in the raw water also increased with increasing TMP in the range of 0.01-0.05 MPa. High ZP induced by PAC1, such as 5-9 mY, led to an increase in the number of fine and total particles in the MCR, and consequently caused serious membrane fouling and high permeate turbidity. However, the removal of TOC and DOC increased with increasing ZP. A slightly positive ZP, such as 1-2 mV, corresponding to charge neutralization coagulation, was favorable for membrane fouling control. Moreover, dosing with KMnO4 could further improve the removal of turbidity and DOC, thereby mitigating membrane fouling. The results are helpful for the application of the MCR in producing drinking water and also beneficial to the research and application of other coagulation and membrane separation hybrid processes.展开更多
文摘BACKGROUND The incidence of Barrett’s esophagus(BE)in China is lower compared to the Western populations.Hence,studies conducted in the Chinese population has been limited.The current treatment options available for BE treatment includes argon plasma coagulation(APC),radiofrequency ablation and cryoablation,all with varying degrees of success.AIM To determine the efficacy and safety of HybridAPC in the treatment of BE.METHODS The study cohort consisted of patients with BE who underwent HybridAPC ablation treatment.These procedures were performed by seven endoscopists from different tertiary hospitals.The duration of the procedure,curative rate,complications and recurrent rate by 1-year follow-up were recorded.RESULTS Eighty individuals were enrolled for treatment from July 2017 to June 2020,comprising of 39 males and 41 females with a median age of 54 years(range,30 to 83 years).The technical success rate of HybridAPC was 100%and the overall curative rate was 98.15%.No severe complications occurred during the operation.BE cases were classified as short-segment BE and long-segment BE.Patients with short-segment BE were all considered cured without complications.Thirty-six patients completed the one-year follow-up without recurrence.Twenty-four percent had mild dysplasia which were all resolved with one post-procedural treatment.The mean duration of the procedure was 10.94±6.52 min.CONCLUSION Treatment of BE with HybridAPC was found to be a simple and quick procedure that is safe and effective during the short-term follow-up,especially in cases of short-segment BE.This technique could be considered as a feasible alternative ablation therapy for BE.
文摘Radiofrequency ablation(RFA)is very effective for eradication of flat Barrett’s mucosa in dysplastic Barrett’s esophagus after endoscopic resection of raised lesions.However,in a minority of the time,RFA may be ineffective at eradication of the Barrett’s mucosa.Achieving complete eradication of intestinal metaplasia can be challenging in these patients.This review article focuses on the management of patients with dysplastic Barrett’s esophagus refractory to RFA therapy.Management strategies discussed in this review include optimizing the RFA procedure,optimizing acid suppression(with medical,endoscopic,and surgical management),cryotherapy,hybrid argon plasma coagulation,and EndoRotor resection.
基金supported by the Special Funds for Technological Development of Research Institutes from the Ministry of Science and Technology of China(Nos.2012EG111122,2013EG111129,2014EG111126)the Program for Overseas Talents from Beijing Academy of Science and Technology(No.OTP-2013-015)the Six Talent Peaks Program from Jiangsu Province(No.JNHB-012)
文摘A submerged internal circulating membrane coagulation reactor （MCR） was used to treat surface water to produce drinking water. Polyaluminum chloride （PAC1） was used as coagulant, and a hydrophilic polyvinylidene fluoride （PVDF） submerged hollow fiber microfiltration membrane was employed. The influences of trans-membrane pressure （TMP）, zeta potential （ZP） of the suspended particles in raw water, and KMnO4 dosing on water flux and the removal of turbidity and organic matter were systematically investigated. Continuous bench-scale experiments showed that the permeate quality of the MCR satisfied the requirement for a centralized water supply, according to the Standards for Drinking Water Quality of China （GB B749-2006）, as evaluated by turbidity （〈1 NTU） and total organic carbon （TOC） （〈5 mE/L） measurements. Besides water flux, the removal of turbidity, TOC and dissolved organic carbon （DOC） in the raw water also increased with increasing TMP in the range of 0.01-0.05 MPa. High ZP induced by PAC1, such as 5-9 mY, led to an increase in the number of fine and total particles in the MCR, and consequently caused serious membrane fouling and high permeate turbidity. However, the removal of TOC and DOC increased with increasing ZP. A slightly positive ZP, such as 1-2 mV, corresponding to charge neutralization coagulation, was favorable for membrane fouling control. Moreover, dosing with KMnO4 could further improve the removal of turbidity and DOC, thereby mitigating membrane fouling. The results are helpful for the application of the MCR in producing drinking water and also beneficial to the research and application of other coagulation and membrane separation hybrid processes.
