玻璃酸钠、去甲肾上腺素、靛胭脂混合溶液在内镜黏膜下剥离术中的临床应用

目的探讨内镜黏膜下剥离术(ESD)治疗时应用玻璃酸钠、去甲肾上腺素、靛胭脂混合溶液黏膜下注射的安全性和可行性。方法收集2010年11月-2011年2月沈阳军区总医院内窥镜科收治的16例经电子染色内镜和超声内镜检查诊断为消化道癌前病变和黏膜下肿物的病例。注射溶液包括0.2%靛胭脂10ml、去甲肾上腺素10mg、玻璃酸钠20mg和生理盐水200ml。于病变处黏膜下注射混合溶液形成液体垫后,利用海博刀行ESD。记录注射溶液用量、切割满意度、剥离成功率、术中出血发生率、穿孔发生率、手术时间、住院时间等。术后随访观察创面的愈合情况及有无复发。结果本组患者切除标本最长径0.8~4.5cm,平均2.2cm;ESD操作时间45~240min,平均95.4min;黏膜下注射总量平均为102.4ml。剥离成功率87.5%。切割满意度良好。所有患者均未发生穿孔,仅2例结肠侧向发育型肿瘤(LST)患者术中发生较难控制的出血,经热活检钳止血后出血停止。所有病例创面喷洒磷酸铝凝胶,部分创面利用金属夹缝闭。ESD术后平均住院时间为3.8d。结论黏膜下注射玻璃酸钠、去甲肾上腺素和靛胭脂混合液行ESD的效果满意,安全性高。     

青黛炮制过程中靛蓝定向生成的工艺设计与优化

目的 筛选出青黛炮制过程中显著影响靛蓝生成的因素,优化最佳水平组合,确定生成靛蓝的最佳工艺。方法 应用HPLC法测定粗靛中靛蓝;并以鲜叶产靛蓝的量（即靛蓝的转移率）为指标,采用Plackett-Burman设计,Box-Behnken设计效应面分析等统计学方法,筛选出显著影响因素及最佳水平组合。结果 青黛的浸泡、打靛工艺确定为浸泡前不除蜡,浸泡液pH 3.5,溶剂用量与鲜叶质量比例为13,避光、浸泡24 h,温度25 ℃,通气时间30 min,加氨水调节打靛前pH值至9。结论 系统地优化了青黛浸泡、打靛环节的工艺,阐明了青黛炮制过程中各个影响因素对有效成分靛蓝的影响,为炮制原理的研究奠定了基础。     

青黛炮制过程中靛蓝定向生成的工艺设计与优化

目的筛选出青黛炮制过程中显著影响靛蓝生成的因素,优化最佳水平组合,确定生成靛蓝的最佳工艺。方法应用HPLC法测定粗靛中靛蓝;并以鲜叶产靛蓝的量(即靛蓝的转移率)为指标,采用Plackett-Burman设计,Box-Behnken设计效应面分析等统计学方法,筛选出显著影响因素及最佳水平组合。结果青黛的浸泡、打靛工艺确定为浸泡前不除蜡,浸泡液pH 3.5,溶剂用量与鲜叶质量比例为13,避光、浸泡24 h,温度25℃,通气时间30 min,加氨水调节打靛前pH值至9。结论系统地优化了青黛浸泡、打靛环节的工艺,阐明了青黛炮制过程中各个影响因素对有效成分靛蓝的影响,为炮制原理的研究奠定了基础。     

Endoscopic imaging in Barrett’s esophagus

Barrett’s esophagus is the only known precursor that predisposes patients to the development of esophageal adenocarcinoma. The current recommended surveillance method is targeted biopsies of any abnormalities followed by random four-quadrant biopsies every 2 cm using standard white light endoscopy. Compliance with this and sampling error are two of the biggest problems. Several novel imaging technologies have been developed to aid the diagnosis of early neoplasia in Barrett’s esophagus. There are emerging data that some of these new modalities can increase the yield of detecting dysplasia. This review will discuss some of the present available techniques and technologies including chromoendoscopy, narrow-band imaging, autofluorescence imaging, optical coherence tomography, confocal endomicroscopy and endocytoscopy. Based on the current evidence, these imaging modalities appear to be promising as adjunctive tools to white light endoscopy. A few of them, nevertheless, remain experimental due to expense, lack of expertise, generalizability as well as reproducibility of results.     

不同氮素形态和浓度对大青叶生物量与生物碱类成分的影响

目的:分析不同氮素形态及不同浓度氮素施肥对大青叶生物量与生物碱类成分的影响,为研究提高菘蓝对氮素的利用效率提供理论依据。方法:采用大棚砂培种植菘蓝,正交设计L₂₅(5),以大青叶的生物量及靛蓝、靛玉红含量为指标,分析3因素硝态氮(N0₃-N)、铵态氮(NH₄-N)和酰胺态氮 [CO(NH₂)₂]和5种不同氮素浓度对菘蓝的影响。结果:不同的氮素形态和浓度对大青叶生物量与生物碱类成分含量的影响存在较大差异,酰胺态氮对大青叶生物量的影响最大,铵态氮对靛玉红影响更大;综合考虑其生物量与生物碱成分含量,优选出1个最佳的施氮组合,即17号组合(NH₄)₂SO₄浓度为7.5 mmol·L, KNO₃浓度为2.5 mmol·L,CO(NH₂)₂浓度为5 mmol·L。结论:菘蓝前期以促生长为主,经济有效的平衡施氮组合能合理促进菘蓝植株生长,提高大青叶的活性成分的含量和单株生物量。     

依匹斯汀与蜈黛软膏联合液氮冷冻治疗慢性湿疹疗效观察

目的观察依匹斯汀与蜈黛软膏联合液氮冷冻治疗慢性湿疹的疗效。方法将80例慢性湿疹患者随机分成治疗组和对照组,治疗组口服依匹斯汀片,每次20mg,每日1次,外用蜈黛软膏,每日早晚各1次,同时联合液氮冷冻治疗,苔藓样变皮损冷冻治疗时间需延长至皮损颜色变白,然后复温,间隔两分钟再治疗1次,一般冻融1．2次,皮损颜色变为紫黑色为宜,剩余皮损冷冻治疗隔日1次;对照组口服依匹斯汀片,每次20mg,每日1次,外用糠酸莫米松软膏,每日1次,两组疗程均为1个月。结果治疗组总有效率为92．5％,对照组总有效率为72．5％,两组比较差异有显著性（P〈0．05）。结论依匹斯汀与蜈黛软膏联合液氮冷冻治疗慢性湿疹疗效确切,副作用小,患者易耐受,值得在临床上推广使用。     

HPLC法同时测定残黄片中靛蓝和靛玉红的含量

目的建立残黄片中靛蓝和靛玉红的含量测定方法。方法采用HPLC法,色谱柱：Alltima C18（5μm,250mm×4.6 mm）反相柱;流动相：甲醇-水（80∶20）;流速：1.0 ml·min-1,检测波长：287 nm;柱温：30℃。结果靛蓝和靛玉红含量分别在4.34～17.34μg（r=0.9999）和2.32～9.28μg（r=0.9998）范围内线性关系良好,平均回收率分别为99.50%和100.34%,RSD分别为1.27%和0.63%（n=6）。结论该方法操作简便,准确可靠,专属性强,重复性好,能同时测定残黄片中靛蓝和靛玉红的含量,可用于残黄片的质量控制。     

红花饮片染色掺伪品的检测方法探讨

目的比较红花饮片及其染色掺伪品外观性状的区别,并建立TLC及HPLC方法,检测红花饮片中所使用的染料酸性红73和胭脂红。方法采用TLC法对红花中的酸性红73和胭脂红进行了定性鉴别;采用HPLC法分别对酸性红73、胭脂红进行测定和定量分析。结果红花中酸性红73和胭脂红的薄层色谱鉴别及HPLC测定特征明显,专属性强。结论方法简单可行,重复性好,可准确检测红花染色掺伪品中的酸性红73和胭脂红。     

智能分光比色技术与靛胭脂染色大肠镜检查随机对照试验Meta分析

目的系统分析比较智能分光比色技术(FICE)与靛胭脂染色(IC)对提高大肠病变检出率的临床运用价值。方法使用以下关键词:"flexible spectral imaging color enhancement","indigo carmine","colonoscope","colonic lesions","colon tumor"、"chromoendoscopy"、"虚拟色素内镜"、"靛胭脂质"、"结肠镜"、"色素内镜"、"结肠病变"、"结肠癌"、"结肠息肉"和"灵活的光谱成像色彩增强"检索Pub Med、CINAHL数据库、万方数据库、维普数据库、中国知网和Cochrane图书馆数据库2008年1月-2013年1月之间的相关文章,通过排除最终纳入8篇文章,所有的数据进行了分析。结果用比值比(OR)结果的95%可信区间(CI)评估的检测方法和检测率之间的相关性。肿瘤病变(OR=0.90,95%CI:0.76~1.08,P=0.255)、非肿瘤性病变(OR=1.09,95%CI:0.92~1.30,P=0.302)、腺瘤(OR=0.87,95%CI:0.72~1.07,P=0.188)、非肿瘤性息肉(OR=0.84,95%CI:0.67~1.06,P=0.146)、平坦型病变(OR=0.87,95%CI:0.71~1.08,P=0.203)、隆起性病变(OR=1.23,95%CI:0.93~1.64,P=0.153)、右半结肠病变(OR=0.83,95%CI:0.60~1.14,P=0.251)、横向结肠病变(OR=0.71,95%CI:0.48~1.05,P=0.086),两者左半结肠病变(OR=1.35,95%CI:1.01~1.80,P=0.045)之间比较,差异具有统计学意义。结论除了左半结肠的病变以外,FICE和IC之间的结肠病变检测率差异无统计学意义。     

Colon Polyps Detected by Contrast Chromoscopy Using Indigo Carmine Capsule

Contrast chromoscopy of the colon using indigo carmine capsule was performed in 287 patients from July 1990 to March 1991. The distribution and histological features of the polyps detected and resected in these patients were investigated. The overall prevalence of polyps (neoplastic and nonneoplastic) was 85.7% and that of neoplastic polyps was 57.1 %. Moreover, the prevalence of neoplastic polyps in 121 asymptomatic patients was 50.4%. A total of 1179 polyps were resected. Of this total, 1049 polyps were diminutive (>5 mm), and 130 polyps were >5 mm. Histological examinations revealed 35.6% of the diminutive polyps and 83.7% of the large polyps (>5 mm) were neoplastic. Proximally, diminutive neoplastic polyps predominated, accounting for 78% of all of the diminutive polyps in the right colon. The situation was reversed in the distal colon, where diminutive non-neoplastic polyps comprised 91% of all of the diminutive polyps in the rectum. The number of large polyps was evenly distributed throughout the colon. The incidence of carcinoma was 0.5% of the diminutive polyps and 10.1 % of the large polyps. Approximately 70% of all of the neoplastic polyps were located proximal to the sigmoid colon. These findings suggest that there are many more polyps present throughout the colon than previously estimated. This suggests that total colonoscopy be performed more thoroughly than before, by using for instance chromoscopy. Furthermore, all of the polyps encountered during colonoscopy should be removed due to the high prevalence of neoplasia, especially in the proximal side of the colon.