HPLC法测定脑脉泰胶囊中银杏总黄酮的含量

目的:建立高效液相色谱法测定脑脉泰胶囊中银杏总黄酮含量的方法。方法:色谱柱:伊利特-C_(18)柱(250mm×4.6 mm,5μm),流动相:乙腈-甲醇-水(9:39:52),磷酸调节pH至4.0,流速:0.8ml·min~(-1),检测波长:370nm,柱温:35℃。结果:槲皮素、山奈素、异鼠李素检测浓度的线性范围分别为4.20～25.20(r=0.999 7),4.85～29.10(r=0.999 5),2.02～12.12μg·ml~(-1)(r=0.999 2);平均回收率分别为99.90%,100.10%,98.33%,RSD分别为0.63%,0.80%,0.99%。结论:本法快速、简便、准确、重复性好,可用于脑脉泰胶囊的质量控制。     

低分子肝素联合百令胶囊治疗肾病综合征

目的：探讨低分子肝素（LMWH）联合百令胶囊对原发性肾病综合征（PNS）的临床疗效。方法：将临床确诊108例PNS病例随机分为对照组36例（常规激素治疗）;LMWH组38例（常规激素加用LMWH）;治疗组34例（在常规激素基础上加用LMWH联合百令胶囊）。检测治疗前后各纽24h Upro、Alb、Tc、Scr,BUN、PT、Pit变化。结果：治疗8周后,治疗组治疗前后24h Upro、Tc显著降低。Alb显著升高（P〈0．01）,且明显优于对照组（P〈0．01）及LMWH组（P〈0．05）。结论：在激素基础上加用LMWH联合百令胶囊治疗PNS能更有效地提高疗效,改善预后。     

正常吸毒者口服脱毒舒胶囊Ⅰ期临床耐受性试验

目的：评价正常吸毒者口服脱毒舒胶囊的安全性和耐受性。方法：43名正常吸毒受试者进行单次及多次给药的耐受性试验。其中,单次给药者31人,经筛选合格后随机分配到7个剂量组（1、2、3、4、5、6和7粒组）。多次给药者12人,男女各半,分为3粒组和4粒组,连续给药6d,前3d1d2次,1次3（或4）粒;后3d1d2次,1次2粒。观察记录给药前后不同时间的体格检查、生命体征、心电图、血常规、尿常规、血液生化等指标。结果：给药后体格检查、体征未见有临床意义的改变。实验室检查中单次组共有4组（3、4、5、6粒给药组）的BUN值和两组（3、7粒给药组）的Cr值试验前后变化有统计学意义（P〈0．05）,多次给药两组的BUN值和Cr值试验前后变化都有统计学意义（P〈0．05）;少数病例的CK值变化有临床意义,但该组均数前后变化分析无统计学差异。试验中不良事件均为轻中度且为一过性,未见严重不良事件发生。结论：脱毒舒胶囊单次给药1～7粒,受试者均可耐受;多次给药（前3d早晚各4粒,后3d早晚各2粒）受试者可以耐受。推荐Ⅱ期临床研究用药剂量为多次给药,疗程6d,前3d早晚各4（或3）粒,后3d早晚各2（或1）粒,但需注意受试者睡眠、饮食、心肌酶和大小便等的变化。     

黄体酮胶丸用于早期先兆流产保胎治疗效果观察

目的：探讨黄体酮胶丸用于早期先兆流产保胎治疗的效果。方法：采用口服黄体酮胶丸（口服组）和肌内注射黄体酮（肌注组）治疗先兆流产患者30例,对比观察其临床症状、体征及血清孕酮（P）水平。结果：两组间临床症状、体征及P水平差异均无显著性。结论：口服黄体酮胶丸与肌内注射黄体酮治疗先兆流产均有良好疗效,但口服治疗较方便可行,而且患者能得到较好的休息,避免肌内注射引起的疼痛。所以黄体酮胶丸用于治疗黄体功能不全所致的先兆流产效果安全、可靠,具有可行性。     

Evaluation of capsule endoscopy in active, mild-to-moderate, overt, obscure GI bleeding

BACKGROUND: The role of capsule endoscopy (CE) in the diagnosis of active mild-to-moderate GI bleeding (GIB) immediately after a negative EGD and ileocolonoscopy has not been prospectively evaluated. OBJECTIVE: To estimate the diagnostic yield and clinical significance of CE in patients with acute, obscure, overt, mild-to-moderate GIB. DESIGN: A single-center prospective study. PATIENTS: During a 3-year period, 573 patients admitted to the hospital with acute mild-to-moderate GIB were included in this study. Among them, 37 patients (6.5%) with negative endoscopic findings, after urgent upper- and lower-GI endoscopies, underwent CE within the first 48 hours to identify the source of bleeding. RESULTS: CE revealed active bleeding in 34 patients and a diagnostic yield of 91.9%, including angiodysplasias in 18 patients, ulcers in 3 patients, and tumors in 2 patients. In the remaining 11 patients (32%), CE revealed the site of bleeding: distal duodenum in 1 case (9%), jejunum in 6 cases (54%), ileum in 2 cases (18%), and cecum in 2 cases (18%). From the 37 bleeders, 16 were managed conservatively, 14 endoscopically, and 7 surgically. During a 12-month follow-up period, bleeding recurrence was observed in 5 of 32 (15.6%). LIMITATIONS: This study had a limited number of patients. CONCLUSIONS: CE appeared to have a high diagnostic yield in patients with acute, mild-to-moderate, active hemorrhage of obscure origin when performed in the hospital after a negative standard endoscopic evaluation and has important clinical value in guiding medical management.     

A prospective study of the utility of abdominal radiographs after capsule endoscopy for the diagnosis of capsule retention

BACKGROUND: Capsule retention is a rare but serious complication of capsule endoscopy (CE). The utility of routine abdominal radiographs after CE for the diagnosis of capsule retention is not established. OBJECTIVE: To establish the utility of abdominal radiographs in the diagnosis of capsule retention in patients undergoing CE. DESIGN: Prospective cohort study. PATIENTS: Consecutive patients undergoing CE. SETTING: Mayo Clinic Scottsdale, Arizona, a multispecialty academic medical center. INTERVENTION: Abdominal radiographs were performed on days 3, 7, and 14 after CE. If the patient visualized passage of the capsule, the subsequent abdominal radiograph was cancelled. MAIN OUTCOME AND MEASUREMENTS: Capsule retention, defined as the capsule endoscope seen on the day-14 abdominal radiograph. RESULTS: A total of 115 patients (46% men; mean age 65 years, range 20-88 years) underwent CE, which was performed for obscure GI bleeding in 86%, for suspected Crohn's disease in 5%, and for other indications in 9%. Thirty-four patients (30%) reported spontaneous passage of the capsule by day 3 and an additional 2 patients by day 7. Of the 81 reporting nonpassage by day 3, 66 (82%) underwent abdominal radiographs. Abdominal radiographs in 14 of 66 patients (21%), 3 of 12 (25%), and 2 of 3 (66%) showed a retained capsule on day 3, 7, and 14, respectively. Three patients (2.6%) were diagnosed with capsule retention. Two had serial abdominal radiographs: capsule retention was detected on the day-14 radiographs, and both underwent surgery. Histopathology revealed diaphragm disease of the small intestine in both patients. One patient who did not have serial abdominal radiographs had a small-bowel tumor as the cause of his capsule retention. In all 3 patients, the colon was not visualized on CE. CONCLUSIONS: Capsule retention is a rare but serious complication of CE. Most patients do not visualize capsule passage. For patients who do not visualize capsule passage and, in whom the colon is not visualized on the video imaging, an abdominal radiograph on day 14 will help identify those with capsule retention.     

Effect of mosapride on gastrointestinal transit time and diagnostic yield of capsule endoscopy

BACKGROUND AND AIM: Since its introduction, capsule endoscopy (CE) has made it possible to visualize the small intestine mucosa directly. However, owing to the limited battery life, only 60-80% of the capsules could reach the cecum and would possibly affect the diagnostic yield. The aim of this study was to determine the effect of oral mosapride on gastrointestinal transit time and the diagnostic yield of CE. METHOD: Sixty patients were involved in this randomized, prospective and controlled study. The patients were randomly allocated to groups receiving either mosapride citrate or nothing. Patients in the mosapride group (n = 30) received 10 mg mosapride citrate 1 h before CE examination, while patients in the control group (n = 30) received no preparation. The gastrointestinal transit time, the number of CE reaching the cecum, and the diagnostic yield of each group were assessed in a single-blinded fashion. RESULT: Gastric emptying time was significantly shorter in the mosapride group than in the control group (13.5 min vs 34 min P = 0.035). Compared with the control group, the complete transit rate was significantly higher in the mosapride group (93.3% vs 66.7% P = 0.021). There was no significant difference between the two groups on the small bowel transit time and diagnostic yield. CONCLUSION: Mosapride citrate accelerates the gastric emptying and completion rate of small bowel examination in patients undergoing CE.     

Safety and efficacy of the M2A patency capsule for diagnosis of critical intestinal patency: results of a prospective clinical trial

BACKGROUND AND AIM: The presence of a critical intestinal stricture is a contraindication for conventional capsule endoscopy for the risk of impaction. Prior assessment of intestinal patency can substantially minimize this risk. The aim of the present study was to assess the safety and efficacy of the M2A patency capsule (PC) for verification of intestinal strictures. METHODS: The M2A PC consists of a biodegradable body surrounding a small radiofrequency identification (RFID) tag. This capsule was administered to patients with known or suspected intestinal strictures. Patency was verified if the capsule was excreted intact. The capsule disintegrated into small fragments and only the RFID tag was excreted if retained at the stricture beyond a stipulated time. The patency scanner was used to detect the RFID tag externally. The M2A video capsule (VC) was administered to patients who excreted the intact capsule. RESULTS: Twenty-six patients with known or suspected intestinal strictures were administered the M2A PC. This included 16 (61%) patients with tuberculosis, eight (31%) with Crohn's disease, and one each of postoperative and malignant strictures. Eight capsules were excreted intact within 72 h and two at 109 and 110 h. Fifteen capsules disintegrated in the G(I) tract and one capsule was removed during surgery. No PC-related complications were noted. Six of the eight patients who tested positive for patency were tested with the regular M2A VC with normal excretion. CONCLUSION: The M2A PC is a reliable indicator of functional patency in suspected or even known cases of intestinal stricture. It could be used prior to conventional capsule endoscopy to predict and minimize the risk of impaction.