胶囊内镜临床应用37例分析

目的 评价胶囊内镜对小肠疾病的诊断价值及其对途经的食管、胃、大肠病变的诊断价值，观察患者使用胶囊内镜的顺应性和安全性。方法 2002年10月至2003年3月，对37例受检者进行了38次检查。其中健康志愿者10例，有消化道症状者27例。结果胶囊内镜检查发现的小肠病变有26例：毛细血管扩张症、静脉扩张、黏膜脂肪斑各4例，多发性溃疡(和)出血2例，蛔虫症3例，淋巴滤泡重度增生5例，异物3例，息肉l例。并且检出了食管炎7例、慢性胃炎27例，胆汁反流性胃炎4例，NSAID相关性胃炎及小肠病变l例，十二指肠炎症5例，及十二指肠球部、结肠溃疡等病变。胶囊内镜图像清晰。受检者顺应性良好，无任何并发症。结论 胶囊内镜对小肠病变具有较好的检出能力，对途经的上、下消化道也有一定的诊断价值，尤其适用于怀疑小肠疾病以及不宜行创伤性检查的消化道疾病患者。     

叶下珠胶囊治疗慢性乙型肝炎的临床研究

目的：观察叶下珠胶囊治疗慢性乙型肝炎的临床疗效。方法：治疗组（135例）口服叶下珠胶囊，4粒／次，3次／d；对照组（54例）口服灭溴灵胶囊，4粒／次，3次／d。两组患者均服药3个月，观察其治疗前后（部分患者随访1年）HBV－M，HBV DNA，肝功能及症状变化情况。结果：治疗组HBeAg,HBV DNA的阴转率分别为59．0％，65．4％，对照组为14．0％，17．4％，P＜0．05，差异有显著性意义治疗组和对照组总有效率分别为71．0％，18．5％，P＜0．01，差异有非常显著性意义。随访1年，其中治疗组68例，对照组25例，治疗组HBsAg，HBeAg，HBV DNA阴转率分别为22．0％，73．5％，72．0％，对照组分别为4．0％，24．0％，23．5％，P＜0．05，差异有显著性意义。两组总有效率分别为92．6％，84．0％，P＜0．05，差异有显著性意义。结论：叶下珠胶囊治疗慢性乙型肝炎具有良好疗效，远期疗效满意。     

胶囊内镜对小肠疾病的诊断价值分析

目的 了解胶囊内镜检查在国人运用的临床特性，评价胶囊内镜对国人小肠疾病的诊断价值。方法 分析55例次胶囊内镜检查的临床资料。结果 (1)53例受检者进行了55次胶囊内镜检查，成功54次，成功率为98．2％。53例受检者均耐受了检查，未出现并发症。(2)胶囊内镜在胃内滞留平均时间为44min(6—135min)，小肠内滞留平均时间为334min(90—433mim)。在检查记录有效期间，胶囊内镜顺利通过回盲瓣42例，未通过12例。52例胶囊在检查结束后顺利排出体外，排出平均时间为24h(5h 10min～72h)。(3)检出了小肠癌、淋巴瘤、息肉、平滑肌瘤、黄色瘤、克罗恩病、非特异性炎症、蛔虫症、鞭虫症、异物及血管畸形等。结论 胶囊内镜检查操作简单、安全、有效，检查成功率高，对小肠黏膜、血管及黏膜下等病变的检出能力较小肠钡剂灌肠、血管造影为高，具有较好的诊断价值。胶囊内镜的最大缺点是观察不能重复，不能获得组织学诊断和较为准确的定位诊断。     

Clinical outcome of patients examined by capsule endoscopy for suspected small bowel Crohn''s disease

BACKGROUND: Capsule endoscopy has a greater diagnostic yield than radiology for detecting subtle inflammatory changes of the small bowel mucosa, but the clinical significance of these abnormalities is still uncertain because of the lack of long-term follow-ups. AIM AND METHODS: To verify the accuracy of capsule endoscopy in a cohort of patients with suspected Crohn's disease of the small bowel, taking as 'gold standard' the final diagnosis made after a long follow-up. From April 2002 to March 2005, we enrolled and examined by capsule endoscopy 27 consecutive patients with abdominal pain and diarrhea lasting more than 3 months and at least one of the following: anaemia, weight loss, fever, extra-intestinal manifestation(s) of inflammatory bowel disease. All patients already had an unremarkable pan-endoscopy, serology for celiac disease and intestinal radiology inconclusive for small bowel abnormality. On the basis of capsule endoscopy findings, patients were distributed in three groups; Group A had severe stricturing lesions requiring surgery; Group B, moderate inflammatory lesions further investigated invasively; Group C, minimal inflammatory changes or normal findings, clinically observed every 3 months (median 21 months, range 15-29). RESULTS: Small bowel inflammatory lesions were found in 16 of the 27 patients (diagnostic yield 59%). Three had surgery (Group A) and Crohn's disease was confirmed in two; the remainder had ileal adenocarcinoma in a pathological context of chronic inflammation. Crohn's disease was histologically confirmed in four of the five patients in Group B. Group C comprised 19 patients; Crohn's disease was confirmed in seven out of eight with positive capsule endoscopy, while only one of the patients with normal findings later developed overt ileal Crohn's disease. Sensitivity, specificity, positive and negative likelihood ratio were, respectively, 93%, 84%, 5.8 and 0.08. Assuming a 50% pre-test probability of disease, capsule endoscopy gave a post-test probability of 85%. CONCLUSIONS: In our selected cohort, capsule endoscopy was highly sensitive in detecting small bowel inflammatory changes, enhancing by nearly 35% the pre-test probability of structural small bowel disease. Focal erythema and luminal debris may limit the specificity of capsule endoscopy.     

Occult intestinal haemorrhage due to lipoma of the small bowel detected with the combined use of the new endoscopic techniques. A report of two cases

We report two unusual cases of occult intestinal bleeding due to lipoma of the small bowel. Both the patients underwent several inconclusive endoscopic and radiological procedures before the diagnosis of these lesions that was possible using video capsule endoscopy and double balloon enteroscopy. In the first case, the finding of capsule endoscopy was confirmed using enteroscopy, allowing us to diagnose the ileal mass. In the second and more recent case, we used double balloon enteroscopy for the further characterisation and management of the ileal lipoma. Lipoma is a very rare cause of intestinal bleeding and we describe the management and the outcome of our patients.     

比色法测定肉豆蔻八味胶囊中总黄酮含量

目的对肉豆蔻八味胶囊中总黄酮的含量进行测定。方法以芦丁为对照品,用亚硝酸钠-硝酸铝-氢氧化钠显色后,在504 nm波长下测定。结果 3批肉豆蔻八味胶囊中总黄酮的含量分别为21.15,20.58,20.43 mg/g,平均加样回收率为98.42%,RSD为1.13%（n=6）。结论该方法简便、准确,重复性好,可作为肉豆蔻八味胶囊的质量控制方法。     

高效液相色谱法测定麻黄止嗽胶囊中盐酸麻黄碱及盐酸伪麻黄碱含量

目的：建立测定麻黄止嗽胶囊中盐酸麻黄碱及盐酸伪麻黄碱含量的高效液相色谱法。方法色谱柱为C18柱（250 mm ×4.6 mm,5μm）,流动相为乙腈-0.1%磷酸（3：97）梯度洗脱,流速为1.0 mL/min,检测波长210 nm。结果盐酸麻黄碱进样量在0.02~3.12μg范围内、盐酸伪麻黄碱在0.01~1.52μg范围内与峰面积积分值线性关系良好（ r=0.9999）;3种质量浓度盐酸麻黄碱的加样回收率分别为99.26%,99.44%,105.10%,盐酸伪麻黄碱的加样回收率分别为100.48%,102.75%,100.50%。结论该方法简便、准确,可用于控制该制剂的质量。     

加味桂已合方治疗卵巢囊肿的临床疗效

目的：探讨加味桂已合方治疗卵巢囊肿的临床疗效。方法：选择卵巢囊肿患者60例,其中30例患者给予桂枝茯苓胶囊口服为对照组,30例患者给予加味桂己合方治疗为研究组,比较两组患者的临床疗效。结果：研究组综合疗效总的有效率、中医症候积分改善率显著高于对照组,比较差异有统计学意义（P〈0．01）。治疗后研究组和对照组囊肿三径之和均显著小于治疗前,比较差异有统计学意义（P〈0．01）;但治疗后组间比较差异无统计学意义（P〉0．05）。结论：加味桂己合方治疗卵巢囊肿具有较好的临床疗效。     

舒心胶囊对缺氧诱导人脐静脉内皮细胞凋亡及相关基因表达的影响

观察舒心胶囊对缺氧诱导人脐静脉内皮细胞凋亡及相关基因表达的影响。体外培养人脐静脉内皮细胞 ,建立缺氧模型 ,以透射电子显微镜技术、流式细胞术 (膜联蛋白v/碘化丙啶 )双染色鉴定细胞凋亡 ;流式细胞术检测Fas、bcl 2及p5 3蛋白表达。缺氧培养 12h后 ,电镜显示细胞呈典型凋亡形态 ,双染色流式细胞仪检测凋亡细胞比例 (13.0 3%± 0 .96 % )显著高于正常组 (4 .4 7%± 0 .6 4 % ) (P <0 .0 1) ,而加入 5g/L舒心胶囊原液缺氧培养 12h后 ,凋亡细胞显著减少 (5 .0 3%± 0 .5 4 % ) (P <0 .0 1)。Fas蛋白表达在缺氧损伤过程中未见改变 ,舒心胶囊可使bcl 2蛋白表达升高 ,p5 3蛋白表达降低。舒心胶囊能够抑制缺氧诱导人脐静脉内皮细胞凋亡 ,可能与其升高bcl 2表达、降低p5 3表达有关。     

祛栓灵胶囊对急性血瘀模型兔和大鼠血液流变学的改善研究

目的观察祛栓灵胶囊对急性血瘀模型动物兔和大鼠的血液流变学的影响。方法动物ig祛栓灵胶囊7 d后,分别以iv 10%高分子右旋糖酐和sc肾上腺素加冰浴制备兔和大鼠急性血瘀模型,然后分别测定血液流变学指标的变化。结果兔连续ig祛栓灵胶囊37.5~150 mg/kg 7 d后,可降低高分子右旋糖酐血瘀模型兔的全血黏度、全血还原黏度和红细胞聚集指数。大鼠连续ig祛栓灵胶囊62.5~250 mg/kg 7 d后,同样可降低sc肾上腺素+冷刺激所致急性血瘀模型大鼠的全血黏度、血浆黏度、红细胞压积和纤维蛋白原。结论祛栓灵胶囊对急性血瘀兔和大鼠的血液流变学指标具有一定的改善作用。