BACKGROUND Gastric cancer,a prevalent malignancy,poses a severe threat to the health of residents in China.Timely intervention in early stages can extend patients’survival.AIM To analyze clinical characteristics of p...BACKGROUND Gastric cancer,a prevalent malignancy,poses a severe threat to the health of residents in China.Timely intervention in early stages can extend patients’survival.AIM To analyze clinical characteristics of patients with early gastric cancer and efficacy and risk of complications associated with endoscopic resection.METHODS This study included 175 patients with early gastric cancer treated at our hospital,with no restrictions on sex or age.General data,pathological information,and endoscopic biopsy results were obtained.The clinical characteristics of early gastric cancer were analyzed,and endoscopic resection was performed.Postoperative efficacy and incidence of complications were monitored.Statistical analysis was performed using SPSS 26.0 and GraphPad Prism 8.0 software.RESULTS A total of 175 patients with early gastric cancer were included,with 75.43%(n=132)males and 24.57%(n=43)females.38.29%(n=67)and 35.43%(n=62)of patients had a history of smoking and alcohol consumption,respectively.Comorbidities included diabetes(8.57%,n=15),coronary heart disease(10.29%,n=18),and hypertension(43.43%,n=76),which was highly prevalent.A history of abdominal surgery and family history of digestive system cancer accounted for 21.14%and 17.14%,respectively.The most common lesion location was the antral part of the stomach(52.00%,n=91),followed by the gastric angle,body,and fundus.The pathological types were predominantly high-grade intraepithelial neoplasia(28.00%,n=49)and well-differentiated adenocarcinoma(26.86%,n=47),followed by moderately differentiated adenocarcinoma,high-moderately differentiated adenocarcinoma,and moderate-lowly differentiated adenocarcinoma.89.14%of the patients had intestinal metaplasia and 85.14%had atrophy.After endoscopic resection,re-examination revealed that 13 patients had cancer cells at the tissue margin,with a positive margin rate of 7.43%.Postoperative complications included no cases of gastrointestinal obstruction,but incisional infection(2.86%,n=5),gastric perforation(1.14%,n=2),and gastric bleeding(4%,n=7)were present,with an overall incidence of 8.00%.CONCLUSION Analysis of the clinical characteristics indicated that early gastric cancer is more prevalent in males with a history of hypertension,with lesions most commonly occurring in the antral region of the stomach.The pathological types are often high-grade intraepithelial neoplasia and well-differentiated adenocarcinoma,with over 85%of patients having comorbid intestinal metaplasia and atrophy.Despite endoscopic resection,a positive margin rate persisted,indicating a probability of residual cancer at the margins.Postoperative complications,such as gastrointestinal obstruction,incisional infection,gastric perforation,and gastric bleeding can occur and require timely symptomatic treatment.展开更多
Hypertriglyceridemia is a well-recognized etiology of acute pancreatitis,and the incidence of hypertriglyceridemic acute pancreatitis(HTG-AP)has increased in frequency worldwide in response to lifestyle changes.It is ...Hypertriglyceridemia is a well-recognized etiology of acute pancreatitis,and the incidence of hypertriglyceridemic acute pancreatitis(HTG-AP)has increased in frequency worldwide in response to lifestyle changes.It is crucial to identify hypertriglyceridemia as the cause of pancreatitis and initiate appropriate treatment.Insulin treatment produces effective lowering of triglycerides,but in our opinion,non-diabetic patients with HTG-AP require separate consideration to avoid hypoglycemia.展开更多
We reviewed a study that reported a comparative analysis of the effects of endoscopic mucosal resection(EMR)precutting and conventional EMR for removing non-pedunculated,10-20 mm sized colorectal polyps.We identified ...We reviewed a study that reported a comparative analysis of the effects of endoscopic mucosal resection(EMR)precutting and conventional EMR for removing non-pedunculated,10-20 mm sized colorectal polyps.We identified some statistical deficiencies in this study.In addition,we believe that the differences between the treatments failed to achieve significance,and therefore,further analysis is required.展开更多
We reviewed a study addressing the development and validation of a prediction model for moderately severe and severe acute pancreatitis in pregnancy. We identified some statistical deficiencies in this article. In add...We reviewed a study addressing the development and validation of a prediction model for moderately severe and severe acute pancreatitis in pregnancy. We identified some statistical deficiencies in this article. In addition, we believe that the role of cholesterol as a predictor should be described in more detail.展开更多
BACKGROUND Intramural esophageal dissection(IED)is a rare disease that should be considered in patients with chest pain,dysphagia,and hematemesis.Although it occurs most frequently in older adult women with impaired c...BACKGROUND Intramural esophageal dissection(IED)is a rare disease that should be considered in patients with chest pain,dysphagia,and hematemesis.Although it occurs most frequently in older adult women with impaired coagulation or as a sequela of endoscopy,the incidence of spontaneous IED without an obvious causative agent has risen gradually.CASE SUMMARY This report describes a case of extensive annular IED in a 75-year-old male patient who presented with dysphagia for the past month.Esophageal barium meal radiography revealed slow passage of diluted iohexol through the esophagus after swallowing,prominent luminal dilation,obstruction of the lower segment with only a small amount of contrast medium entering the gastric cavity,and no obvious extravasation.Gastroscopy revealed smooth esophageal mucosa;several esophageal mucosal bridges and webbed mucosa were observed approximately 22 cm from the incisor.The mucosal surface was occasionally rough and uneven,and the length of the esophageal mucosal defect exceeded 10 cm.The anatomy was considered to be annular because the mucosal bridge connecting the proximal and distal tube was not attached to the surrounding myotubes.The final diagnosis was spontaneous extensive annular IED.We treated the patient successfully using endoscopic esophagotomy,which completely relieved the symptoms without complications.CONCLUSION Spontaneous annular IED can be treated successfully by endoscopic resection of the mucosal septum between the true and false lumen.展开更多
文摘BACKGROUND Gastric cancer,a prevalent malignancy,poses a severe threat to the health of residents in China.Timely intervention in early stages can extend patients’survival.AIM To analyze clinical characteristics of patients with early gastric cancer and efficacy and risk of complications associated with endoscopic resection.METHODS This study included 175 patients with early gastric cancer treated at our hospital,with no restrictions on sex or age.General data,pathological information,and endoscopic biopsy results were obtained.The clinical characteristics of early gastric cancer were analyzed,and endoscopic resection was performed.Postoperative efficacy and incidence of complications were monitored.Statistical analysis was performed using SPSS 26.0 and GraphPad Prism 8.0 software.RESULTS A total of 175 patients with early gastric cancer were included,with 75.43%(n=132)males and 24.57%(n=43)females.38.29%(n=67)and 35.43%(n=62)of patients had a history of smoking and alcohol consumption,respectively.Comorbidities included diabetes(8.57%,n=15),coronary heart disease(10.29%,n=18),and hypertension(43.43%,n=76),which was highly prevalent.A history of abdominal surgery and family history of digestive system cancer accounted for 21.14%and 17.14%,respectively.The most common lesion location was the antral part of the stomach(52.00%,n=91),followed by the gastric angle,body,and fundus.The pathological types were predominantly high-grade intraepithelial neoplasia(28.00%,n=49)and well-differentiated adenocarcinoma(26.86%,n=47),followed by moderately differentiated adenocarcinoma,high-moderately differentiated adenocarcinoma,and moderate-lowly differentiated adenocarcinoma.89.14%of the patients had intestinal metaplasia and 85.14%had atrophy.After endoscopic resection,re-examination revealed that 13 patients had cancer cells at the tissue margin,with a positive margin rate of 7.43%.Postoperative complications included no cases of gastrointestinal obstruction,but incisional infection(2.86%,n=5),gastric perforation(1.14%,n=2),and gastric bleeding(4%,n=7)were present,with an overall incidence of 8.00%.CONCLUSION Analysis of the clinical characteristics indicated that early gastric cancer is more prevalent in males with a history of hypertension,with lesions most commonly occurring in the antral region of the stomach.The pathological types are often high-grade intraepithelial neoplasia and well-differentiated adenocarcinoma,with over 85%of patients having comorbid intestinal metaplasia and atrophy.Despite endoscopic resection,a positive margin rate persisted,indicating a probability of residual cancer at the margins.Postoperative complications,such as gastrointestinal obstruction,incisional infection,gastric perforation,and gastric bleeding can occur and require timely symptomatic treatment.
文摘Hypertriglyceridemia is a well-recognized etiology of acute pancreatitis,and the incidence of hypertriglyceridemic acute pancreatitis(HTG-AP)has increased in frequency worldwide in response to lifestyle changes.It is crucial to identify hypertriglyceridemia as the cause of pancreatitis and initiate appropriate treatment.Insulin treatment produces effective lowering of triglycerides,but in our opinion,non-diabetic patients with HTG-AP require separate consideration to avoid hypoglycemia.
文摘We reviewed a study that reported a comparative analysis of the effects of endoscopic mucosal resection(EMR)precutting and conventional EMR for removing non-pedunculated,10-20 mm sized colorectal polyps.We identified some statistical deficiencies in this study.In addition,we believe that the differences between the treatments failed to achieve significance,and therefore,further analysis is required.
文摘We reviewed a study addressing the development and validation of a prediction model for moderately severe and severe acute pancreatitis in pregnancy. We identified some statistical deficiencies in this article. In addition, we believe that the role of cholesterol as a predictor should be described in more detail.
文摘BACKGROUND Intramural esophageal dissection(IED)is a rare disease that should be considered in patients with chest pain,dysphagia,and hematemesis.Although it occurs most frequently in older adult women with impaired coagulation or as a sequela of endoscopy,the incidence of spontaneous IED without an obvious causative agent has risen gradually.CASE SUMMARY This report describes a case of extensive annular IED in a 75-year-old male patient who presented with dysphagia for the past month.Esophageal barium meal radiography revealed slow passage of diluted iohexol through the esophagus after swallowing,prominent luminal dilation,obstruction of the lower segment with only a small amount of contrast medium entering the gastric cavity,and no obvious extravasation.Gastroscopy revealed smooth esophageal mucosa;several esophageal mucosal bridges and webbed mucosa were observed approximately 22 cm from the incisor.The mucosal surface was occasionally rough and uneven,and the length of the esophageal mucosal defect exceeded 10 cm.The anatomy was considered to be annular because the mucosal bridge connecting the proximal and distal tube was not attached to the surrounding myotubes.The final diagnosis was spontaneous extensive annular IED.We treated the patient successfully using endoscopic esophagotomy,which completely relieved the symptoms without complications.CONCLUSION Spontaneous annular IED can be treated successfully by endoscopic resection of the mucosal septum between the true and false lumen.
