Complete defect closure after endoscopic submucosal dissection (ESD) could decrease delayed adverse events [1]. Although various endoscopic instruments are used to suture post-ESD defects, such as the Overstitch device [2] and loop string-assisted clip device [3], these devices either cost a lot or require complicated manipulation. Therefore, we developed a string-with-knotter device (VDK-FH-A-11-180; Jiangsu Vedkang Medical Science and Technology Co., Changzhou, Jiangsu, China) [4] to easily and reliably close a gastric post-ESD defect ([Video 1]).
Objective To study the safety and effect of betadine irrigation of stomach for preventing infection during natural orifice transluminal endoscopic surgery （NOTES）. Methods The clinical data of 9 patients receiving transgastric NOTES at our center from March 2009 to June 2010 were reviewed. After general anesthesia, the stomachs were lavaged with 200 to 300 ml betadine. Then the endoscope was maneu- vered in the peritoneal cavity after the creation of the gastronomy, and some procedures were performed with assistance of laparoscope. A total of 5 ml stomach fluid was collected before and after lavage, and 5 ml of peritoneal fluid was collected at the end of the procedure. At last the gastronomy was closed with clips. Fol- low-up endoscopy was performed 1 week and 6 months after NOTES, respectively. Results All the surgical procedures were performed successfuliy, 5 of which under aid of laparoscope. The gastric fluid collected be- fore lavage was negative for bacteria in 2 patients, and enteric bacilli was the main bacteria in the stomach fluid of other 7 patients, with an average bacterial load of 35.6 ×10^3 CFU/ml. No bacteria was cultured in gastric fluid after lavage and peritoneal fluid after NOTES. No inflammation, ulcer or bleeding was observed under endoscopy 1 week after NOTES. No surgical complications including infection occurred in 6 months after NOTES. Conclusion Betadine irrigation of stomach is safe and effective for preventing infection during NOTES. Further studies are needed for assessing the effectiveness and safety of betadine irrigation in NOTES.
Key words:
Infection; Natural orifice transluminal endoscopic surgery; Povidone-Iodine; Transgastric approach; Clinical protocols
MiR-196a levels inversely correlated with survival in pancreatic adenocarcinoma patients. However, the functional contributions of miR-196a to pancreatic cancer remain unclear.Three lentiviral vectors encoding microRNA miR-196a precursor, inhibitor, and scrambled microRNA oligomer were transfected into Panc-1 cells, respectively. Then we explored the regulation of inhibitor of growth 5 (ING5) expression by miR-196a and its impact on apoptosis, invasion, and growth of pancreatic cancer cells. The lentiviral transfected Panc-1 cells were surgically implanted into the pancreas of mice. In vivo tumor growth and ING5 expression were measured.Down-regulation of ING5 expression was detected in cells transfected with miR-196a precursor (P < 0.01), accompanied by less apoptosis, increased invasion, and proliferation compared with control cells (P < 0.05). Cells transfected with miR-196a inhibitor revealed an opposite trend. Smaller detectable tumors were found in only 60% of mice after implantation of Lenti.miR-196a inhibitor-transfected Panc-1 cells compared with controls (360.7 ± 303.6 mm vs 511.58 ± 365.9 mm in controls; P < 0.01).Our results provide experimental evidence to support aberrant expression of miR-196a is associated with abnormal apoptosis, invasion, and proliferation of pancreatic cancer cells.
TO THE EDITOR: We thank Dr. Herszenyi, Dr. Kaya, Dr. Andriulli, and their colleagues for their thoughtful letters. These letters pointed out the disadvantages of our multicenter trials. The following major concerns were raised by the three previous letters:
// Jiulong Zhao 1, * , Chunhua Zhou 1, 2, * , Mao Li 1, * , Jialing Li 1 , Guixiang Li 1 , Dan Ma 1 , Zhaoshen Li 1 and Duowu Zou 1 1 Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China 2 Department of Gastroenterology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China * These authors have contributed equally to this work Correspondence to: Duowu Zou, email: zdw_pi@163.com Keywords: molybdenum disulfide; ultra-small; bottom-up; cell nucleus; photothermal therapy Received: June 27, 2017 Accepted: August 27, 2017 Published: November 08, 2017 ABSTRACT The two-dimensional molybdenum disulfide (MoS 2 ) nanosheet has been extensively studied as a novel photothermal transducing agent. However, top-down exfoliation to produce MoS 2 nanosheets is inefficient, and MoS 2 nanosheet surface modification procedures are complex. Here, we report the synchronous synthesis and surface modification of 2D MoS 2 nanosheets with a polyvinylpyrrolidone (PVP)-assisted one-pot hydrothermal method. Due to the chelating-coordinating effect between the lone-pair electrons of the PVP carbonyl oxygen and the unoccupied 4d orbitals of molybdenum, the PVP chains could graft onto the surface of MoS 2 and guide the growth of the nanosheets. The resultant MoS 2 -PVP nanosheets were ultra-small (21.4 ± 4.4 nm) and exhibited excellent colloidal stability. Moreover, the strong near-infrared absorption of the MoS 2 -PVP nanosheets enabled sensitive photothermal conversion performance (with a mass extinction coefficient of 23.33 L g −1 cm −1 ) and in vitro / in vivo photoacoustic imaging. The MoS 2 -PVP nanosheets had excellent in vitro and in vivo compatibility and were used for highly efficient tumor photothermal therapy in xenograft tumor-bearing mice. The findings in this report will facilitate the rational design of stable colloidal 2D transition-metal dichalcogenides for effective photothermal cancer therapy.
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