Objective To evaluate the efficacy and safety of polyethylene glycol electrolyte powder(PEG)combined with linaclotide(Lin)for bowel preparation in elderly constipated patients before colonoscopy.Methods In this prospective,randomized controlled trial,90 elderly patients with constipation undergoing colonoscopy were recruited at our hospital from June 2022 to December 2023.Participants were randomly assigned to three groups(n=30 each):PEG-3L alone,PEG-3L+Lin,and PEG-2L+Lin.Primary outcome was Boston Bowel Preparation Scale(BBPS)score and secondary outcomes included adverse event rates,colonoscopy completion rate,withdrawal time,and polyp detection rate.Statistical analysis was performed using independent t-tests and chi-square tests.Results The PEG-3L+Lin group achieved significantly higher BBPS scores than both PEG-3L alone and PEG-2L+Lin groups did(both P<0.001).The PEG-2L+Lin group also outperformed the PEG-3L alone group in cleansing efficacy(90.0%vs.76.7%,P=0.008).The PEG-2L+Lin group demonstrated the best tolerability and lowest adverse event rate,the PEG-3L group had the longest withdrawal time(P<0.05),but the three groups showed no significant difference in polyp detection rates.Conclusion PEG combined with linaclotide significantly improves bowel cleansing in elderly constipated patients.PEG-2L+Lin regimen provides optimal balance between efficacy,safety,and tolerability,making it a preferable choice for this population.

Objective To evaluate the efficacy and safety of polyethylene glycol electrolyte powder(PEG)combined with linaclotide(Lin)for bowel preparation in elderly constipated patients before colonoscopy.Methods In this prospective,randomized controlled trial,90 elderly patients with constipation undergoing colonoscopy were recruited at our hospital from June 2022 to December 2023.Participants were randomly assigned to three groups(n=30 each):PEG-3L alone,PEG-3L+Lin,and PEG-2L+Lin.Primary outcome was Boston Bowel Preparation Scale(BBPS)score and secondary outcomes included adverse event rates,colonoscopy completion rate,withdrawal time,and polyp detection rate.Statistical analysis was performed using independent t-tests and chi-square tests.Results The PEG-3L+Lin group achieved significantly higher BBPS scores than both PEG-3L alone and PEG-2L+Lin groups did(both P<0.001).The PEG-2L+Lin group also outperformed the PEG-3L alone group in cleansing efficacy(90.0%vs.76.7%,P=0.008).The PEG-2L+Lin group demonstrated the best tolerability and lowest adverse event rate,the PEG-3L group had the longest withdrawal time(P<0.05),but the three groups showed no significant difference in polyp detection rates.Conclusion PEG combined with linaclotide significantly improves bowel cleansing in elderly constipated patients.PEG-2L+Lin regimen provides optimal balance between efficacy,safety,and tolerability,making it a preferable choice for this population.

To evaluate the feasibility and safety of dilation treatment under the guidance of precise puncture assisted with double endoscopes for anastomotic atresia after colorectal cancer surgery, 3 cases with anastomotic atresia after colorectal cancer surgery were treated precisely under endoscopy. The first colonoscopy was introduced through the terminal ileum stoma to anastomotic site, another endoscope was inserted through the anus to the anastomosis. Precise puncture of the contralateral intestinal cavity was done through light source positioning. The puncture needle was seen under the direct vision of endoscope, and then the guide wire was inserted. Anastomosis was dilated by the balloon through the guide wire. Endoscopic recanalization of anastomotic atresia was successfully completed in 3 patients. No complication occurred during the treatment with the mean operation time of 44.3 minutes. The ileal terminal stoma reduction surgery was performed 1-3 months after endoscopic treatment. Dilation treatment under the guidance of precise puncture assisted with double endoscopes for anastomotic atresia after colorectal cancer surgery is reliable with the advantages of short operation time, safety and convenience, and no need for X-ray assistance.

To evaluate the feasibility and safety of dilation treatment under the guidance of precise puncture assisted with double endoscopes for anastomotic atresia after colorectal cancer surgery, 3 cases with anastomotic atresia after colorectal cancer surgery were treated precisely under endoscopy. The first colonoscopy was introduced through the terminal ileum stoma to anastomotic site, another endoscope was inserted through the anus to the anastomosis. Precise puncture of the contralateral intestinal cavity was done through light source positioning. The puncture needle was seen under the direct vision of endoscope, and then the guide wire was inserted. Anastomosis was dilated by the balloon through the guide wire. Endoscopic recanalization of anastomotic atresia was successfully completed in 3 patients. No complication occurred during the treatment with the mean operation time of 44.3 minutes. The ileal terminal stoma reduction surgery was performed 1-3 months after endoscopic treatment. Dilation treatment under the guidance of precise puncture assisted with double endoscopes for anastomotic atresia after colorectal cancer surgery is reliable with the advantages of short operation time, safety and convenience, and no need for X-ray assistance.

Objective To explore the diagnostic value of endobronchial ultrasound?guided transbronchial needle aspiration ( EBUS?TBNA) in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results of EBUS?TBNA. Methods A retrospective analysis of the clinical and imaging data of 389 patients who underwent EBUS?TBNA for sampling enlarged hilar and mediastinal lymph nodes from October 2009 to October 2015 in Shandong Tumor Hospital, to evaluate its significance in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results. Results Among the 389 collected cases, positive biopsy results were obtained in 362 cases, and false negative results in 27 cases. The sensitivity, specificity, positive predictive value and negative predictive value were 92. 9%, 100%, 100% and 25. 0%, respectively. There was a positive correlation between the size of lymph node and biopsy positive rate (P=0.021). The subcarinal lymph nodes had the highest positive rate ( 97. 7%) , followed by the paratracheal lymph nodes ( 91. 2%) , with a statistically significant difference (P=0.006). The positive rates obtained by cytology (88.7%) and pathology (92.5%,) showed no significant difference ( P=0. 065 ) . The positive rate of EBUS?TBNA was not correlated with pathological types (P=0.932). Needle types (21G, 22G) had no significant effect on diagnosis accuracy (P=0.142). Conclusions EBUS?TBNA is a practical technology for diagnosis of enlarged mediastinal lymph nodes, with unique characteristics such as minimally invasiveness, local anesthesia, good safety and repeatability. Along with the accumulation of surgical experience, improvement of operative skills, more close cooperation between surgeons, cytologists and pathologists, false negative results will be reduced and positive rate of EBUS?TBNA examination will be further improved.

Objective To explore the diagnostic value of endobronchial ultrasound?guided transbronchial needle aspiration ( EBUS?TBNA) in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results of EBUS?TBNA. Methods A retrospective analysis of the clinical and imaging data of 389 patients who underwent EBUS?TBNA for sampling enlarged hilar and mediastinal lymph nodes from October 2009 to October 2015 in Shandong Tumor Hospital, to evaluate its significance in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results. Results Among the 389 collected cases, positive biopsy results were obtained in 362 cases, and false negative results in 27 cases. The sensitivity, specificity, positive predictive value and negative predictive value were 92. 9%, 100%, 100% and 25. 0%, respectively. There was a positive correlation between the size of lymph node and biopsy positive rate (P=0.021). The subcarinal lymph nodes had the highest positive rate ( 97. 7%) , followed by the paratracheal lymph nodes ( 91. 2%) , with a statistically significant difference (P=0.006). The positive rates obtained by cytology (88.7%) and pathology (92.5%,) showed no significant difference ( P=0. 065 ) . The positive rate of EBUS?TBNA was not correlated with pathological types (P=0.932). Needle types (21G, 22G) had no significant effect on diagnosis accuracy (P=0.142). Conclusions EBUS?TBNA is a practical technology for diagnosis of enlarged mediastinal lymph nodes, with unique characteristics such as minimally invasiveness, local anesthesia, good safety and repeatability. Along with the accumulation of surgical experience, improvement of operative skills, more close cooperation between surgeons, cytologists and pathologists, false negative results will be reduced and positive rate of EBUS?TBNA examination will be further improved.