1.Endoscopic super minimally invasive surgery for superficial neoplasia associated with submucosal tumor at the same position of upper digestive tract
Baojie ZHU ; Ningli CHAI ; Shengzhen LIU ; Qianqian CHEN ; Enqiang LINGHU
Chinese Journal of Digestive Endoscopy 2023;40(8):610-615
Objective:To explore the clinical characteristics of superficial neoplasia associated with submucosal tumor (SMT) located at the same position and the efficacy of endoscopic super minimally invasive surgery (SMIS).Methods:Data of 9 patients who were diagnosed as having superficial neoplasia associated with SMT at the same position in the upper digestive tract and treated with digestive endoscopic SMIS at the First Medical Center of PLA General Hospital from January 2011 to December 2021 were retrospectively analyzed. Data including basic information, endoscopic diagnosis and treatment, pathological results and follow-up of these patients were collected to analyze their clinicopathological characteristics. The postoperative pathology and incidence of complications were used as the gold standard to assess the effectiveness and safety of SMIS.Results:In the 9 patients, there were 8 males and 1 female with mean age of 61.6±11.7 years. The main symptoms were abdominal pain in 3 cases, abdominal discomfort in 2 cases, and dysphagia in 1 case. Seven patients were diagnosed as having superficial neoplasia before surgery, while SMT was found during surgery. One patient with superficial neoplasia associated with SMT and 1 with SMT were diagnosed before the surgery. The common sites of the lesion were esophagus (3 cases), gastric antrum (3 cases), cardia (2 cases) and fundus (1 case). The Paris classification of all lesions was type Ⅰ, Ⅱa or combinations. The most common pathological type was early cancer with leiomyoma in 5 cases. All lesions met the criteria of en bloc resection. One lesion had positive lateral margin with low-grade intraepithelial neoplasia, four were all completely resected. No complications such as bleeding, perforation or infection occurred in this study. Follow-up date were available in all cases with a mean period of 19-81 months and no recurrence or metastasis was discovered.Conclusion:The symptoms of patients with superficial neoplasia associated with SMT located at the same position are often atypical. The endoscopic type of lesions is usually protrusion or partial protrusion. Most are diagnosed as having superficial neoplasia before the surgery, and SMT are usually found coincidentally. The most common pathological type is early cancer with leiomyoma. SMIS is safe and effective for the complex lesion.
2.Clinical Efficacy and Regulation of Skin Microbiota in Children with Atopic Dermatitis and Damp-heat Accumulation Syndrome Treated with Zhaqu Xiaofeng Powder (楂曲消风散)
Xueer ZHANG ; Shengzhen YE ; Pai ZHENG ; E LIU ; Siqi ZHAO ; Xinwan XIAO ; Jing GUO
Journal of Traditional Chinese Medicine 2024;65(8):810-820
ObjectiveTo assess the clinical efficacy and regulation of skin microbiota in children with atopic dermatitis and damp-heat accumulation syndrome treated by Zhaqu Xiaofeng Powder (楂曲消风散, ZXP). MethodsNinety children were randomized into a treatment group and a control group, each with 45 children. The treatment group received ZXP orally, while the control group received levocetirizine hydrochloride syrup, both for 4 weeks. The atopic dermatitis severity index (SCORAD)score, visual analog scale (VAS)score for itching, children dermatology life quality index (CDLQI)score, and traditional Chinese medicine syndrome score were assessed before and after 2- and 4-week treatment. Simultaneously, adhering to the principles of sample size in microbial sequencing, 25 children were randomly selected from each group (total 50 children); skin samples were collected before and after treatment, and skin specimen DNA was extracted for 16S rRNA gene amplifier sequencing; the skin microbiota levels were detected, and the distribution of bacteria, diversity of flora, and differences between groups were compared. ResultsThere were five drop-outs in each group, and 40 cases in each group were included in final analysis.