OBJECTIVES: To establish a system for control of cross-infection and workflow for preventing severe acute respiratory syndrome coronavirus 2 spread and ensuring the safety of medical staffs and patients in endoscopy center during the pandemic of the coronavirus disease 2019 (COVID-19). METHODS: Based on the national publication of relevant documents and relevant guidance of Digestive Endoscopy Branch of Chinese Medical Association, we explored and optimized the workflow, staff protection and sterilization of endoscope in digestive endoscopy center during the pandemic of the COVID-19. RESULTS: The prevention system of cross-infection and workflow in endoscopy during the pandemic of the COVID-19 were developed. The optimized workflow in endoscopy was conducted in 106 patients with necessary endoscopy from the Department of Gastroenterology, Third Xiangya Hospital, Central South University between January 24, 2020 and February 26, 2020, and no case of cross-infection was presented among the medical staffs, patients and family members. CONCLUSIONS Measures on control of cross-infection and workflow in digestive endoscopy center during the pandemic of the COVID-19 are effective, which are beneficial to preventing cross-infection in hospital and provide a scientific guidance for the general work in the digestive endoscopy centers during the pandemic of the COVID-19.
Betacoronavirus ; China ; Coronavirus Infections ; epidemiology ; prevention & control ; Cross Infection ; prevention & control ; Endoscopy ; Gastroenterology ; organization & administration ; Humans ; Pandemics ; prevention & control ; Pneumonia, Viral ; epidemiology ; prevention & control ; Workflow

Objective:To detect the changes in mental arithmetic competence and the related influencing factors in patients with early Parkinson's disease(PD)by using mental arithmetic task behavioral experiment.Methods:Thirty-one patients with early PD and 40 healthy controls were enrolled in this study.The cognitive functions were tested by mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA). The differences of mental arithmetic competence between the two groups were measured by behavioral experiment.Results:There was no significant difference in correct rate, reaction time and post-corrected reaction time while performing baseline tasks and easy mental arithmetic tasks between the two groups( P>0.05). The reaction time had no significant difference between the two groups after adjusting some confounding factors( P>0.05). However, the correct rate while performing difficult mental arithmetic tasks was significantly lower( t=-2.232, P=0.029)and the reaction time was significantly longer( t=2.149, P=0.035)in PD group than in the controls, and the significant difference in reaction time persisted even after adjusting some confounding factors( t=3.139, P=0.003). In PD group, the correct rate of difficult mental arithmetic tasks was positively associated with MoCA scores( r=0.561, P=0.004), and negatively associated with age( r=-0.532, P=0.008). The reaction time and post-corrected reaction time while performing difficult metal arithmetic task were negatively associated with MoCA scores( r=-0.525, P=0.01; r=-0.554, P=0.005)and positively associated with age( r=0.485, P=0.037; r=0.514, P=0.012)in PD group. Conclusions:The difficult mental arithmetic competence is impaired in early PD patients, which is statistically significantly correlated with cognitive function and age.

To evaluate the feasibility and safety of colon stenting as bridge surgery for colorectal cancer obstruction.
 Methods: A total of 30 patients (stent group), who underwent colonic stenting for colorectal obstruction at the Third Xiangya Hospital, Central South University from September 2015 to June 2017, were selected to receive the preoperative bridge surgery. Technical success rates, clinical success rates, and stent-related complications were observed. A total of 38 patients (emergency surgery group), who underwent surgical operation for colorectal obstruction, served as a control. The tumor resection rate at Stage I, ostomy rate, hospitalization time, and hospitalization cost were compared between the 2 groups.
 Results: The technical success and clinical success rates were 100.0% and 90.0% in the stent group, respectively. The stent-related complications included bleeding in 2 cases (6.7%), micro-perforation in 1 case (3.3%), stent displacement in 1 case (3.3%), and stent occlusion in 3 cases (10.0%) in the stent group. The Stage I tumor resection rate in the stent group was significantly higher than that in the emergency surgery group (90.0% vs 68.4%, P<0.01). The incidence of anastomotic leakage in the stent group was lower than that in the emergency surgery group (3.3% vs 10.5%, P<0.05); the stoma rate in the stent group was lower than that in the emergency surgery group (13.3% vs 44.7%, P<0.01). The surgical complications occurred in the stent group were significantly lower than those in the emergency surgery group (20.0% vs 47.3%, P<0.01). The average hospital stay in the stent group was lower than that in the emergency surgery group (20.0 vs 24.5 days, P<0.05). There was no significant difference in hospitalization costs between the 2 groups (P>0.05).
 Conclusion: Preoperative colonic stenting for colorectal obstruction surgery as a bridge is feasible in terms of methods, and which can significantly increase the Stage I tumor resection rate, reduce the ostomy rate, decrease surgical complications, shorten the average length of hospital stay, and reduce patient suffering.
Colorectal Neoplasms ; complications ; Humans ; Intestinal Obstruction ; etiology ; therapy ; Stents ; Treatment Outcome

Objective:To explore the function of esophageal small balloon or papillary sphincter knife in the treatment of stent implantation for colorectal malignant obstruction,and to improve the success rate of colonic stent placement in such patients.Methods:A total of 49 patients with colorectal cancer complicated with almost complete obstruction or colorectal cancer were enrolled for this study.The esophageal small balloon or papillary sphincter knife was used in the guide wires.The guide wires gradually crossed the tumor gap and they were placed in the contralateral intestinal cavity with balloon progression.X-ray was then used to confirm whether the guide wire was inserted in the lesion intestinal cavity,and then the metal bare stent was inserted.Results:The guide wires was successfully inserted with conventional methods in these 49 cases,while they were also successfully placed the guide wire and the stent in the new way.Conclusion:For the patients with colorectal cancer complicated with complete obstruction or colorectal cancer located in obviously angled location,the use of esophageal small balloon or papillary sphincter knife can help the guide wire insert.They greatly improve the success rate of stent implantation.

OBJECTIVE:To explore the effectiveness and safety of probucol combined with rosuvastatin in the treatment of vascu-lar dementia(VD). METHODS:In retrospective study,clinical information of 88 VD patients selected from neurology department of our hospital during May 2013-Feb. 2015 were divided into observation group and control group according to therapy plan,with 44 cas-es in each group. Both groups received conventional treatments such as controlling blood pressure and blood glucose,anticoagulation. Control group was additionally given Rosuvastatin calcium tablets orally 20 mg,at bedtime;observation group was additionally given Probucol tablet 0.5 g,bid,after meal,on the basis of control group. Both groups received treatment for consecutive 3 months. MMSE and ADL score were compared between 2 groups before and after treatment as well as the levels of TC,TG,LDL-C,HDL-C,CRP, TNF-α,IL-6,IL-1β,SOD and MDA. The occurrence of ADR was also observed. RESULTS:Before treatment,there was no statisti-cal significance in above indexes between 2 groups(P>0.05). Compared to before treatment,MMSE and ALD score,serum SOD lev-el of 2 groups were increased significantly,while serum levels of TC,TG,LDL-C,CRP,TNF-α,IL-6,IL-1βand MDA were de-creased significantly after treatment,with statistical significance(P<0.05). Above indexes of observation group were significantly bet-ter than those of control group,with statistical significance(P<0.05). There was no statistical significance in HDL-C level between 2 groups before and after treatment (P>0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05).CONCLUSIONS:Probucol combined with rosuvastatin is better than rosuvastatin alone in reducing blood lipid,serum inflamma-tory factors and oxidant stress indexes levels,improving cognitive function and quality of life with good safety.

Objective To investigate the affecting factors on auditory and speech performances in preschool children with unilateral cochlear implantation (CI) .Methods The clinical data of the preschool children (n=165) with unilateral cochlear implantation in the Second Xiangya hospital from January 2006 to April 2013 were collected . These children received rehabilitation according to the method recommended by the China Rehabilitation Research Center for Deaf Children ,and the data were analyzed retrospectively .The categories of auditory performance (CAP) and speech intelligibility rating (SIR) were used to assess their auditory and speech performances .The relationships between the performance and gender ,implanted age ,genotype ,inner ear malformation ,history of hearing aid were evaluated .Results Implanted ages and genotypes were associated with the auditory and speech performance of par‐ticipants (P<0 .05) ,while genders ,hearing aid experience ,and inner ear malformations(enlarged vestibular aque‐duct syndrome ,EVAS)were not significant related (P<0 .05) .Children were found to have achieved better CAP and SIR growths when CI was implanted during 1~3 years old and 2~4 years old ,respectively (P<0 .05) .The outcomes of CI recipients with GJB2 mutation were significantly better than those of the GJB2-nonrelated CI recipi‐ents (P<0 .05) .Conclusion This study provides evidence that CIs during first 1~3 years old having better auditory rehabilitation results than those of during 4~6 years old ,and CIs during 2~4 years old obtaining a better speech development in the first 12 months after operation .Deaf children with GJB2 mutation show better auditory and speech performances after CIs than those of the peers without GJB2 mutation .CIs can be effectively performed in deaf children associated with EVAs as in those without EVAS .

OBJECTIVE: To evaluate the curative effect and safety of endoscopic full-thickness resection (EFR) in the treatment of gastric tumor originated from the muscularis propria.
 METHODS: Clinical data were collected from 34 patients, who underwent EFR of gastric tumor originated from muscularis propria, to observe the resection rate and complications from November 2012 to August 2014.
 RESULTS: Of the 34 patients, 15 were male, 19 were female, with the age of 38.3-70.6 (52.3±4.3) years old. The lesions of 25 patients located in the fundus of stomach and the rest was in the gastric body. EFR was successfully performed in the 34 patients with no need for surgery. The complete resection rate was 100%. Lesion diameter ranged from 1.0 to 5.0 (2.8±1.2) centimeters. The operation time was 50-100 (76.5±18.2) min. Patients with pneumoperitoneum were relieved after abdominal puncture exhaust, without post-operation bleeding and perforation. The hospitalization duration was 3-5 (3.6±0.8) days. Except 1 case, the remaining 33 cases were spindle cell tumors, consistent with the results of immunohistochemistry. The risk for two lesions with 4.5 cm and 5.0 cm was moderate. The risk of invasion was low or very low in the remaining 31 cases. Among them, 2 stromal tumors near the cardia showed a differentiation tendency toward smooth muscle. No lesion residual or recurrence happened during the follow-up period (range 5-23 months) in 34 cases. 
 CONCLUSION EFR is a safe and effective method for gastric tumor originated from muscularis propria.
Adult ; Aged ; Cardia ; Female ; Gastric Fundus ; Gastric Mucosa ; Gastroscopy ; Humans ; Immunohistochemistry ; Length of Stay ; Male ; Middle Aged ; Operative Time ; Stomach Neoplasms

Objective To investigate the Video?Electroencephalography(VEEG)characteristics and abnormal rate among healthy elderly. Meth?ods According to the age,120 healthy elders were divided into groups A,B,and C. Group A has 57 subjects,aged 60?69 years old;group B has 42 people,aged 70?79 years;group C has 21 individuals,aged≥80 years. Chi square and Rank sum test were used to calculate abnormal rate of VEEG. Additionally,characteristics of alpha、slow wave and Iconic sleep wave were analyzed. Result The total abnormal rate of VEEG was 42.5%, and it was particularly high(76.2%)among elderly over 80s. Frequency,amplitude,reactivity of Alpha wave and alpha index decreased as age in?creased. Theta slow wave increased as age increased,abnormal frontal area theta showed an increase among elderly over 80 s. Each sleep cycle iconic sleep wave was gradually decreased in the elderly. No statistical difference was found about sleep spindles and vertex sharp among different groups . Positive occipital sharp transients of sleep(POSTS)decreased as age increased. There was no POSTS among elderly over 80 s. Conclusion Our re?sults showed that abnormal rate is increased in the elderly,while reactivity variation,slow alpha frequency,alpha amplitude,alpha index are de?creased. In addition,the slow waves in frontal area is increased,. sleep cycles becomes less distinct,and the typical wave are decreased.

Objective To observe the effects of hydrotalcite on histological ulcer healing quality in patients with Helicobacter pylori (Hp) positive active gastric ulcer .Methods A total of 145 patients with H p positive active gastric ulcer were divided into two groups .The control group was treated with esomeprazole ,amoxicillin and furazolidone triple therapy .The treatment group was treated with above triple therapy and hydrotalcite .After four-week treatment ,gastroendoscopy was repeated .The sections of gastric biopsy specimens were stained with hematoxylin-eosin (HE) staining ,Van Gieson staining , Alcian blue-periodic acid stiff (AB-PAS ) staining , streptavidin-perosidase (SP ) immunohistochemistry staining and computer imaging analysis technology were applied to observe maturity type of mucosal structure at the margin of ulcer ,the content of collagen and neutral mucus ,and the changes of expression of epithelial growth factor receptor (EGFR) and basic fibrobast growth factor (bFGF) before and after treatment .Paired samples t test was performed for comparison before and after treatment .F test and Chi-square test were used for comparison between two groups .Results The percentage of maturity type of regenerated mucosal structure of treatment group was 62 .9% (39/62) ,however that of control group was 40 .6% (26/64) ,and the difference was statistically significant (χ2 =13 .09 , P=0 .03) .Compared with those before treatment , the content of collagen in granulation tissue and neutral mucus in regenerated mucosa increased in both groups after treatment , and the increase was more significant in treatment group ((55 .1 ± 10 .4)% and (45 .8 ± 7 .1)% ,respectively);and the differences were statistically significant (F= 12 .85 and 18 .17 ,both P<0 .01) .Compared with those before treatment ,the percentage of EGFR and bFGF positive cells of both two groups increased , and the increase was more significant in treatment group ((49 .5 ± 8 .4)% and (48 .8 ± 9 .4)% ,respectively) ,and the differences were statistically significant (F=12 .17 and 18 .73 ,both P<0 .01) .Conclusion Hydrotalcite combined with anti-H p triple therapy can improve the maturity degree of structure and function of regenerated mucosa at the margin of ulcer in patients with H p positive active gastric ulcer and then improve the healing quality of ulcer .

Hepatocellular carcinoma(HCC)has high incidence rate,recurrence rate after surgecal treat-ment,as well as fatality rate in China .HCC is not sensitive to radiotherapy or chemotherapy and no effective treat-ment is available for HCC patients at advanced stage .Sorafenib is the first effective molecularly targeted drug for the treatment of HCC,which represents a milestone in the treatment of HCC .However,it also shows drug resist-ance during clinical application .Therefore,it is important to investigate the mechanism of drug resistance and its molecular markers for HCC .In this review ,we summarize the current status of the studies in these fields .