Diagnostic accuracy of the double-contrast enema for colonic polyps in patients with or without diverticular disease

The accuracy of the double-contrast enema for the diagnosis of polypoid lesions in the presence or absence of diverticula was evaluated by retrospectively reviewing the medical records of 202 patients subjected to examination and endoscopy. Analysis of the data on 215 polypoid lesions showed that (a) the diagnostic accuracy of the examination is not affected significantly by the presence of diverticula; (b) the sensitivity of the examination is highly dependent on the size of the polyps (smaller or larger than 0.5 cm) but not on the form (sessile or pedunculated); and (c) the positive predictive value is higher in patients without diverticula. The doublecontrast enema was confirmed to be a valid method for the diagnosis of polypoid lesions.     

鼻内镜术中不同中鼻甲处理方式治疗慢性鼻-鼻窦炎伴鼻息肉效果比较

探讨慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）患者鼻内镜术中不同中鼻甲处理方式的临床效果。     

Prevention of colorectal cancer by colonoscopic surveillance in families with hereditary colorectal cancer

Objective. In recent years persons at risk for colorectal cancers (CRC) have been subjected to follow-up with colonoscopy in many centres. There is, however, limited knowledge about the effect of such interventions. The objective of this study was to report the results of our observations during the past 15 years. Material and methods. Healthy persons were included in the study according to their family history of CRCs, and prospectively followed with colonoscopies. Results. Altogether, 1133 individuals were included and observed for a total of 3474 follow-up years from the first to the last colonoscopy initiated by our activity. Mismatch repair (MMR) mutations were detected in 6.5% of cases. A total of 1383 polyps were removed, 72% were less than 5 mm in diameter. Findings were scored as hyperplastic polyps (n=887), adenomas with mild to moderate dysplasia (n=460), adenomas with high-grade dysplasia (n=30) and cancers (n=6). Two cancers were observed after the first colonoscopy, compared with 2.6 expected by chance and more than 20 expected under the hypothesis of predominant inherited diseases in the families. Observed annual incidence rates for adenomas were similar in all groups, while in the mutation carriers there was a higher frequency of progression to severe dysplasia or infiltrating cancer. Conclusions. A simple explanation for the combined findings may be that all selected families had a similar tendency to produce adenomas, while mutation carriers more frequently demonstrated dysplasia/cancer in the adenomas. The low annual incidence rates for CRC indicated that the removal of adenomas may have prevented cancers.     

Molecular markers and hepatocellular carcinoma: lending a helping hand in liver transplantation?

Existing and emerging colorectal screening tests can be assessed in terms of the key categories of diagnostic performance, procedural risks, patient acceptability, and cost-effectiveness. To push a new screening test to acceptance, it need not outperform existing strategies in all of these criteria. Rather, a relative advantage in one criterion combined with acceptable performance in the others may be considered adequate. For computed tomographic colonography (CTC), a strong case can be made that this test meets or exceeds optical colonoscopy, the current screening standard, in all of these categories. Published data, including our own experience with CTC screening, will be reviewed to support this claim. Reasons why CTC has not yet achieved its full potential as a valuable screening test for colorectal cancer prevention will also be considered.     

新型胆囊镜的研发与应用

目的：为取石（息肉）保胆手术提供设备支持。 方法：2007年6月至2012年9月，结合胆囊的生理解剖、胆囊疾病的特点、人体工程学及工业设计于一体，研发出新型胆囊镜。 结果：在国家中医药管理局指定的两家医院进行了临床试验，完成取石（息肉）保胆手术120例，并申报国家专利102项，获得国家专利授权82项，获SFAD注册。 结论：研发的取石/息肉保胆手术专用的新型胆囊镜是安全、可靠、有效的取石（息肉）保胆手术器械，为胆囊病的研究提供了新的设备支持。