Applications of gastric peroral endoscopic myotomy in the treatment of upper gastrointestinal tract disease

Gastric peroral endoscopic myotomy(G-POME)is an emerging minimally invasive endoscopic technique involving the establishment of a submucosal tun-nel around the pyloric sphincter.In 2013,Khashab et al used G-POME for the first time in the treatment of gastroparesis with enhanced therapeutic efficacy,prov-iding a new direction for the treatment of gastroparesis.With the recent and rapid development of G-POME therapy technology,progress has been made in the treatment of gastroparesis and other upper digestive tract diseases,such as congenital hypertrophic pyloric stenosis and gastric sleeve stricture,with G-POME.This article reviews the research progress and future prospects of G-POME for the treatment of upper digestive tract gastrointestinal diseases.

Refined Rhubarb Tablets in the Treatment of Acute Hemorrhaging of the Upper Digestive Tract

Refined rhubarb tablets were used to treat 182 cases of acute hemorrhaging of the upperdigestive tract with a total effective rate of 96. 1 % and an average hemostatic time ot 2. 8 days. Prospec-tive and double blind comparative studies of the drug revealed that it had a rernarkably higher hemostaticeffect than compound western medicines (P<0. 01) and was superior to crude rhubarb, which usuallycaused nausea and vomiting and had unstable therapeutic effects- Acute and subacute toxicity determina-tions. genetic toxicologic tests, as well as determinations of various indexes ot blood vessels, pepsin.blood rheology, platelets, bleeding and blood coagulation factors were done, suggesting that refinedrhubarb tablets were nontoxic. safe and effective in local hemostasis and general hemodilution-likehemostasis.

Epidemiological investigation of Barrett's esophagus in patients with gastroesophageal reflux disease in Northwest China

Objective： To investigate the prevalence and possible risk factors of Barrett＇s esophagus （BE） in patients with gastroesophageal reflux disease （GERD） in Northwest China. Methods： Patients older than 18 years who underwent regular health check-up or had upper gastrointestinal symptoms in the endoscopy centers of four major teaching hospitals located in four different provinces of Northwest China from September 2008 to February 2009 were included in the study. A face-to-face reflux diagnostic questionnaire including risk factors were taken and scale scores （So） were accumulated. Diagnostic criterion of GERD was Sc≥12 points. None of these subjects received anti-acid medication prior to their endoscopy done. Barrett＇s esophagus was diagnosed when specialized intestinal metaplasia was detected histologically. Results： A total of 528 patients met the criteria of GERD, among which 32 patients （20 male and 12 female） were diagnosed with BE. BE was present in 6.06% with a mean age of 51.2±11.6 years, which was significantly older than patients with GERD without BE （46.6±13.3 years） （P〈0.05）. There weresignificant differences between BE and GERD patients regarding gender, age, hiatus hernia, smoking and alcohol consumption （P〈0.05）, while no significant difference regarding symptoms of GERD. There was significant difference between short segment Barrett＇s esophagus and long segment （65.6% vs 34.4%, P〈0.05）. Conclusion： The prevalence of BE was 6.06% in patients with GERD in northwest China and was dominated by SSBE. The potential risk factors of Barrett＇s esophagus were older age, male, esophageal hiatal hernia, smoking and alcohol consumption.

Endoscopic profile of caustic burns of the university hospital center of Cocody Abidjan / Côte d’Ivoire

Background:To determine the clinical and endoscopic demographic characteristics of the ingestion of acidic products in the digestive endoscopy unit of the Cocody University Hospital.Methods:This was a retrospective,descriptive and analytical study on endoscopic reports,which took place for five years,from January 1,2014,to December 31,2018.All patients were admitted to the digestive endoscopy unit with the indication of ingestion of caustic products.The parameters studied:are demographic,clinical,and endoscopic.The statistical tests used were Pearson’s CHI 2 and Fisher’s exact tests.The significance threshold was set at 5%.Results:83 patients were included for an endoscopic prevalence of 1.33%.The mean age was 20.77±16.58 years,with extremes ranging from 1 to 63 years.They were divided into 34 men and 49 women for a sex ratio of 0.69.Accidental circumstances were observed in 73.49%of cases,followed by attempted autolysis(26.51%).Bleach was the most offending caustic(75.90%),followed by hydrochloric acid(14.46%).FOGD was normal in 53.01%and revealed stage I(41.54%)digestive lesions,followed by stage II(35.39%)and stage III(21.53%).The lesions were preferentially gastric(36.11%),esogastroduodenal(27.78%),and esogastric(22.23%).Based on severity,54.55%of esophageal lesions were stage IIA,53.12%were stage I gastric lesions,and 54.55%were stage IIA duodenal lesions.One case of gastric perforation was noted(1.54%).In univariate analysis,we found a statistically significant link between the age group of 1–14 years and the accidental intake of caustics(P<0.001)on the one hand and the other hand between the age group of 26 years and over and taking for autolysis(P=0.02).Likewise,bleaching was responsible for less severe lesions(P=0.006).Conclusions:The seriousness of the ingestion of caustic products requires early,specialized and multidisciplinary management to improve the short,medium,and long-term prognosis of patients.