Objective To explore the short-term efficacy of endoscopic submucosal dissection (ESD) in the treatment of early carcinoma in the remnant stomach. Methods A retrospective study was conducted on 45 patients with early residual gastric cancer underwent ESD at the Endoscopy Center of Zhongshan Hospital, Fudan University from December 2014 to April 2024, with a total of 45 lesions. The patients were divided into an anastomotic group (n=15) and a non-anastomotic group (n=30) based on the location of tumor occurrence, and their clinical data, endoscopic diagnosis and treatment, and histopathological conditions were compared between the two groups. Results All 45 patients had lesions with redness and erosion. There were 9 cases of poor lifting of submucosal injection in the anastomotic group and 2 cases in the non-anastomotic group, respectively, and the difference was statistically significant (P<0.05). ESD surgery was performed on 13 lesions in the anastomotic group and 28 lesions in the non-anastomotic group, with surgery times of 80.00 (50.00, 100.00) min and 55.00 (43.75, 80.00) min, respectively. The difference in surgery time between the two groups was statistically significant (P=0.03). Among the 45 patients, ESD surgery achieved curative resection in 35 cases, including 11 cases in the anastomotic group and 24 cases in the non-anastomotic group, with no statistically significant difference. Conclusions Careful preoperative evaluation of early carcinoma in the remnant stomach is essential to prevent oversight. Lesions at anastomotic sites and suture lines present higher technical challenges for complete resection. ESD is safe and effective, with auxiliary traction technique available when necessary.

Objective: To evaluate the feasibility and short-term efficacy of a novel and simplified closure method developed by our team for the defect closure after endoscopic full-thickness resection (EFTR) for gastric submucosal tumors (SMT) in the gastric wall. Methods: A prospective single-arm clinical study was used. Inclusion criteria: (1) the lesion was located in the fundus or the greater curvature of the stomach, and was confirmed to originate from the muscularis propria layer; (2) the diameter of the tumor was ≤3.5 cm, and the tumor had no extensive adhesion to the peritoneal tissues and organs in extraperitoneal cavity; (3) the tumor had no malignant features under ultrasound endoscopy; (4) the patient agreed to participate in the study; (5) patients with severe complications were excluded. Based on the above criteria, 20 patients with gastric SMT at the Endoscopy Center of Zhongshan Hospital of Fudan University from January 2015 to March 2018 were enrolled in this study, including 5 males and 15 females with mean age of 61.1 (38 to 70) years. Grasping forceps-assisted endo-loop snare ligation device which is called "Shao-Mai" method was used to close the defect site. All the patients underwent EFTR and "Shao-Mai" method to perform defect closure. After successful tumor resection by EFTR, an endo-loop was anchored onto the edge of the gastric defect with grasping forceps assistance and closed tightly. The observation indicators included tumor size, en bloc resection, operation time, postoperative complications and hospital stay. The follow-up indicators included tumor residual, local recurrence, and metachronous lesions. Results: All the 20 lesions were located in the muscularis propria with a size of 0.5-3.5 (mean 1.4) cm. Three of them were located in the greater curvature of the mid-upper gastric body, 17 were located in the fundus. The endoscopic "Shao-Mai" closure was successfully performed after EFTR in all the 20 cases. Endoscope was used uniquely through the entire process, without laparoscopic assistance. The operative time was 20-100 (mean 43.8) minutes, while the "Shao-Mai" closure procedure took a range of 3-30 (mean 10.1) minutes. The en bloc resection rate was 100%. The pathological diagnosis included 17 gastrointestinal stromal tumors and 3 leiomyomas. No major complications occurred during or after surgery. All the patients were discharged 1-11 (mean 3.1) days after operation. The wounds of all the cases were healed completely six months after operation and only scar was observed without ulcer. No residual lesion, tumor recurrence or metastasis, leakage or fistula of digestive tract were found during the follow-up period of 15-54 (median 41) months. Conclusion The endoscopic "Shao-Mai" closure method is a simplified novel way, which is feasible, effective, and safe for closing the gastric defect after EFTR.

OBJECTIVE： To establish a method for content determination of total polyphenols from Gastrodia elata， and to optimize the purification technology of macroporous resin. METHODS： The content of total polyphenols from G. elata was determined by Folin-ciocaileu colorimetry. Using the absorption and desorption performance as index， 4 kinds of macroporous adsorption resins were selected by static adsorption and desorption tests. The flow rate and mass concentration of the sampling solution， volume fraction of eluent， eluent flow rate and eluent volume were investigated by dynamic adsorption and desorption tests. The purification technology of macroporous resin was optimized. RESULTS： The linear range of gallic acid was 4-32 μg/mL （r＝0.999 9）. RSDs of precision， stability and repeatability tests were all less than 2％. The recovery rate of the sample was 95.51％-102.94％（RSD＝2.54％，n＝6）. D301 macroporous resin had strong static adsorption and desorption ability from G. elata polyphenols. The optimal purification technology included that the sample solution flow rate 2 BV/h； the sample solution mass concentration 4 mg/mL； the elution solvent 70％ ethanol； the elution flow rate was 3 BV/h， and the eluent volume 5 BV. The content of total polyphenols from G. elata optimized by the optimal purification technology was 0.381 mg/g. CONCLUSIONS： Established method is sensitive and stable. The optimized purification technology is stable and feasible.

Objective To retrospectively study the influence of Shenmai injection on clinical effects and cellular immune function of patients with severe acute pancreatitis (SAP).Methods A total of 70 patients with SAP in our hospital was retrospectively analyzed,and were randomly divided into observation group (traditional therapy and Shenmai injection) and control group (traditional therapy),with 35 cases per group.The general information,the clinical effects,acute physiology and chronic health evaluation Ⅱ scores (the APACHE Ⅱ scores),the immunity indicators (levels of NK T cells,CD4+ T cells,CD8+ T cells,CD4+/CD8+) before and after treatment,the adverse reaction rates in two groups were compared.Results The general information in two groups had no statistically significant difference (P ＞ 0.05).The disappearance of abdominal pain and distension,the time that returned to normal temperature,the first defection,normal levels of amylase in blood and urine,the length of stay in observation group were obviously shorter than that in the control group (P ＜ 0.05).The APACHE Ⅱ scores in two groups after treatment were obviously lower than treatment before,and the levels of immunity indicators after treatment were obviously higher than treatment before (P ＜ 0.05).After treatment,the APACHE Ⅱ score in observation group was obviously lower,and the immunity indicators in observation group were obviously higher than that in the control group (P ＜ 0.05).The adverse reaction rate in observation group was obviously lower than that in control group (5.9％ vs.27.3％,x2 =5.584,P =0.02).Conclusion Shenmai injection can improve the cellular immune function of SAP patients.

Objective To retrospectively study the influence of Shenmai injection on clinical effects and cellular immune function of patients with severe acute pancreatitis (SAP).Methods A total of 70 patients with SAP in our hospital was retrospectively analyzed,and were randomly divided into observation group (traditional therapy and Shenmai injection) and control group (traditional therapy),with 35 cases per group.The general information,the clinical effects,acute physiology and chronic health evaluation Ⅱ scores (the APACHE Ⅱ scores),the immunity indicators (levels of NK T cells,CD4+ T cells,CD8+ T cells,CD4+/CD8+) before and after treatment,the adverse reaction rates in two groups were compared.Results The general information in two groups had no statistically significant difference (P ＞ 0.05).The disappearance of abdominal pain and distension,the time that returned to normal temperature,the first defection,normal levels of amylase in blood and urine,the length of stay in observation group were obviously shorter than that in the control group (P ＜ 0.05).The APACHE Ⅱ scores in two groups after treatment were obviously lower than treatment before,and the levels of immunity indicators after treatment were obviously higher than treatment before (P ＜ 0.05).After treatment,the APACHE Ⅱ score in observation group was obviously lower,and the immunity indicators in observation group were obviously higher than that in the control group (P ＜ 0.05).The adverse reaction rate in observation group was obviously lower than that in control group (5.9％ vs.27.3％,x2 =5.584,P =0.02).Conclusion Shenmai injection can improve the cellular immune function of SAP patients.