Objective:To evaluate the efficacy and safety of modified endoscopic submucosal dissection (ESD) utilizing a mushroom extraction method for gastric ectopic pancreas.Methods:From June 1, 2009 to June 30, 2023, data of 190 patients (191 lesions) with pathologically confirmed heterotopic pancreas who underwent resection using modified ESD with mushroom extraction method in Shandong Second Provincial General Hospital ( n=99) and the 960th Hospital of the PLA Joint Logistics Support Force ( n=91) were retrospectively analyzed. The clinical characteristics and endoscopic and endoscopic ultrasonography (EUS) features were summarized and the treatment effects of the modified ESD was evaluated. The complications and follow-up recurrence were analyzed. Results:Preoperative EUS showed that most lesions originated from the submucosa and often involved multiple layers, invading the muscularis propria in 12 cases. A total of 191 gastric lesions included 174 in the gastric antrum, 2 pyloric canal, 6 gastric body, 7 gastric angle and 2 gastric fundus. The long diameter of the lesions ranged from 0.5-4.0 cm. All patients underwent modified ESD with the mushroom extraction method, and the complete removal rate of specimens was 99.5% (190/191). The operation time was 0.5-2.5 h. There were 10 cases of intraoperative perforation; 1 case of postoperative delayed perforation, 1 case of delayed hemorrhage, and 3 cases of short-term fever. Patients were followed up for 3-5 years after the operation, and no recurrence or metastasis was found.Conclusion:The modified ESD technique incorporating mushroom extraction proves to be a safe and effective approach for the complete removal of gastric ectopic pancreas, minimizing the risk of recurrence and residual pancreatic tissue.

Objective:To evaluate the efficacy and safety of modified endoscopic submucosal dissection (ESD) utilizing a mushroom extraction method for gastric ectopic pancreas.Methods:From June 1, 2009 to June 30, 2023, data of 190 patients (191 lesions) with pathologically confirmed heterotopic pancreas who underwent resection using modified ESD with mushroom extraction method in Shandong Second Provincial General Hospital ( n=99) and the 960th Hospital of the PLA Joint Logistics Support Force ( n=91) were retrospectively analyzed. The clinical characteristics and endoscopic and endoscopic ultrasonography (EUS) features were summarized and the treatment effects of the modified ESD was evaluated. The complications and follow-up recurrence were analyzed. Results:Preoperative EUS showed that most lesions originated from the submucosa and often involved multiple layers, invading the muscularis propria in 12 cases. A total of 191 gastric lesions included 174 in the gastric antrum, 2 pyloric canal, 6 gastric body, 7 gastric angle and 2 gastric fundus. The long diameter of the lesions ranged from 0.5-4.0 cm. All patients underwent modified ESD with the mushroom extraction method, and the complete removal rate of specimens was 99.5% (190/191). The operation time was 0.5-2.5 h. There were 10 cases of intraoperative perforation; 1 case of postoperative delayed perforation, 1 case of delayed hemorrhage, and 3 cases of short-term fever. Patients were followed up for 3-5 years after the operation, and no recurrence or metastasis was found.Conclusion:The modified ESD technique incorporating mushroom extraction proves to be a safe and effective approach for the complete removal of gastric ectopic pancreas, minimizing the risk of recurrence and residual pancreatic tissue.

Background::Carbon monoxide (CO) poisoning remains a major cause of accidental injuries and multiple studies have indicated that CO is also associated with significantly severe or long-term toxicity to the central nervous system. Given that CO poisoning causes serious morbidity and mortality, a better understanding of epidemiological features and clinical characteristics of acute CO poisoning in China is crucial.Methods::We collected the clinical data of acute CO poisoning in patients between November 2019 and April 2020 across Shandong province, China and analyzed its characteristics focusing on the weekly amount and the severity of the confirmed cases.Results::A total number of 21,088 acute CO poisoning cases were diagnosed. The overall incidence of acute CO poisoning was approximately 0.021%. On severity rankings, 63% of confirmed cases ( n = 13,378) were mild, 27% (n = 5635) were moderate, and 10% ( n = 2075) were severe. Interestingly, the coastal cities had more confirmed cases than the inland/suburban areas in Shandong. Meanwhile, the number of confirmed cases was negatively correlated with the local mean daily temperature ( P = 0.0167). Conclusions::Mild acute CO poisoning cases accounted for the majority of all confirmed cases during the winter of 2019. In Shandong province, which is located in east China, residents of the coastal cities are more susceptible to CO poisoning than residents of inland cities.

Objective To observe the clinical effect of hyperbaric oxygen (HBO) coupled with compound Shexiang injection on the patients with diffuse axon injury(DAI).Methods Sixty-eight cases of DAI were randomly divided into the treatment group and the control group,each consisting of 34 cases.The treatment group was treated with HBO coupled with compound Shexiang injection,while the control group was only given Shexiang injection.The clinical prognosis of the patients in the 2 groups was evaluated 6 months after injury by using GOS scores,and the recovery rates of consciousness were compared between the 2 groups.Results The GCS scores of the treatment group were increased markedly,as compared with those of the control group,and the rate of consciousness for the treatment group was obviously superior to that of the control group.Statistical significance could be noted,when comparisons were made between the 2 groups(P ＜ 0.05).Conclusions HBO coupled with compound Shexiang injection could arouse consciousness and prognosis of the patients with DAI.

Objective To observe the clinical effect of hyperbaric oxygen (HBO) coupled with compound Shexiang injection on the patients with diffuse axon injury(DAI).Methods Sixty-eight cases of DAI were randomly divided into the treatment group and the control group,each consisting of 34 cases.The treatment group was treated with HBO coupled with compound Shexiang injection,while the control group was only given Shexiang injection.The clinical prognosis of the patients in the 2 groups was evaluated 6 months after injury by using GOS scores,and the recovery rates of consciousness were compared between the 2 groups.Results The GCS scores of the treatment group were increased markedly,as compared with those of the control group,and the rate of consciousness for the treatment group was obviously superior to that of the control group.Statistical significance could be noted,when comparisons were made between the 2 groups(P ＜ 0.05).Conclusions HBO coupled with compound Shexiang injection could arouse consciousness and prognosis of the patients with DAI.

Objective To explore the clinical application of adaptive support ventilation (ASV) in elderly patients with acute respiratory failure.Methods A total of 46 mechanically ventilated patients aged over 65 years with acute respiratory failure admitted from January 2013 to June 2015 were enrolled.Comparison between the ASV mode and synchronized intermittent mandatory ventilation (SIMV) mode was carried out in respects of the impacts of both modes on respiratory mechanics, hemodynamics, oxygen availability and comfort rate.Results Difference between ASV and SIMV in respiratory rate was [(20.84 ±4.04) vs.(24.50 ±4.60) cycles/min, t =4.04, P ＜0.05], in inspiratory resistance was [(13.24 ±4.76) vs.(16.54±5.25) cmH2O/ (L·s), t=3.16, P＜0.05], in mean airway pressure was [(13.58±2.58) vs.(16.63 ±1.57) mmHg, t =6.84, P＜0.05], in peak airway pressure was [(25.96 ± 3.69) vs.(27.87 ± 2.45) mmHg, t =2.92, P ＜ 0.05], and tidal volume was [(378.41 ± 85.61) vs.(341.52 ± 86.84) mL, t =2.05, P ＜ 0.05], and comfort rate of patients was increased in ASV mode.There were no statistically significant differences in arterial oxygen partial pressure, carbon dioxide partial pressure, lactate, heart rate, mean arterial pressure and central venous pressure between the two modes (PP ＞ 0.05).Conclusions Compared with the synchronized intermittent mandatory ventilation mode, the adaptive support ventilation mode can improve the respiratory mechanics and can increase the comfort rate in the elderly patients with mechanical ventilation.