Detection of abnormal lesions recorded by capsule endoscopy: A prospective study comparing endoscopist''s and nurse''s accuracy

BACKGROUND AND STUDY AIM: Capsule endoscopy is a non-invasive technique for small bowel examination but its evaluation is time consuming. The aim of this study was to assess whether, following adequate training, an endoscopy nurse is capable of picking up all significant images without reducing the diagnostic accuracy of the procedure. PATIENTS AND METHODS: Between April 2003 and December 2004, a total of 41 consecutive capsule endoscopy studies were blindly reviewed by both an endoscopy nurse and an endoscopist. The two operators had to select all significant images independently and to complete a structured questionnaire. Thirty-nine capsule endoscopy examinations (two studies discharged for premature battery failure) were evaluated. The agreement between the two operators was calculated by kappa statistics (coefficient of agreement). RESULTS: Agreement was excellent for all kind of selected lesions (mean kappa>0.85); the agreement was complete (kappa=1) for site identification, active bleeding, stenosis and negative studies. The greater disagreement (kappa=0.77) was found in cases of subtle mucosal abnormalities (i.e. reduction of villi), which were over-estimated by the nurse. CONCLUSIONS: The preview recordings made by the nurse may increase the cost/effectiveness of the study, by considerably reducing the time needed for the endoscopist to make the final report (about 5-10 min), without compromising final diagnosis.     

仙灵骨葆胶囊改善精液质量的临床研究

目的:观察仙灵骨葆胶囊改善男性不育患者精液质量的情况。方法:女方生育功能正常的男性不育患者66例,口服仙灵骨葆胶囊2~4个月,观察治疗前后精液质量并进行精子形态学分析。结果:治疗2个月后,精子密度有所提高,但无统计学差异(P>0.05);精子存活率和活动率也无明显变化(P>0.05);治疗后正常形态精子百分率明显升高,其中正常形态精子百分率≥15%者,由治疗前的25.8%(17/66)增加为57.6%(38/66)(P<0.05),而正常形态精子百分率<9%者,由治疗前的53.0%(35/66)下降为25.8%(17/66);7例少精子症者用药前精子正常形态百分率平均为5.8%,服药4个月后平均为10.9%,与服药前有明显差异(P<0.05)。治疗期间有5例患者配偶怀孕。结论:仙灵骨葆胶囊对男性精液质量有改善作用,能明显提高正常形态精子百分率,少精子症者更明显。     

扶正化瘀胶囊干预慢性乙型肝炎肝纤维化作用的多中心临床研究

目的　研究扶正化瘀胶囊治疗慢性乙型肝炎肝纤维化的临床疗效及其安全性。方法　多中心、随机、双盲、平行对照的方法 ,入选年龄 18～ 65岁的慢性乙型肝炎肝纤维化患者。试验药 (扶正化瘀胶囊 )和对照药 (和络舒肝胶囊 ) ,均为每次 5粒 ,3次 /d口服 ;疗程 2 4周。疗程结束后进行 12周的随访。观测指标 :(1)于治疗第 0、2 4周观察肝组织病理学、HBV标志物 ,第 0、12、2 4周检测肝纤维化血清指标 (HA、LN、P Ⅲ P、Ⅳ C)、B超肝脾检查 ,第 0、6、12、18、2 4周观察肝功能 (随访期评价肝功能、血清肝纤维化指标 )。 (2 )安全性指标 :治疗前、后检测血、尿常规 ,肾功能 ,心电图。结果　 (1)受试者入组情况及人口学资料 :试验组 110例 ,对照组 10 6例 ,两组病例人口学特征、生命体征、病程、药物过敏史、既往治疗史、肝功能、纤维化血清学指标、肝组织病理学 (试验组 99例 ,对照组 96例 )、HBV标志物、肾功能等各项指标比较 ,无显著差异。 (2 )肝组织病理学 :治疗前后作活检肝组织学观察 93例 ,试验组 50例和对照组 43例治疗前纤维化分期 (S)均值分别为 2 .3 3和 2 .11。试验组治疗后S均值为 1.80 ,较治疗前显著下降。对照组治疗后S均值为 2 .14 ,与治疗前比较无显著改善。试验组活检肝组织纤维化分期判断     

中西医结合治疗慢性盆腔炎100例疗效观察

目的:采用中西医结合治疗慢性盆腔炎,减少复发,提高治愈率。方法:对我院门诊患者100例采用胎盘组织液肌注,金钢藤胶囊口服,并用我院自制中药妇炎肠疗液灌肠。结果:临床显效40例,有效56例,无效4例,总有效率96％。结论:中西医结合治疗慢性盆腔炎疗效满意,是目前治疗慢性盆腔炎的最好方法。     

乾坤宁胶囊治疗原发性肝癌的临床观察附：93例病例报告

对照观察了以舒肝解郁，清热解毒，软坚散结，活血化瘀，益气养阴原则配伍而成的乾坤宁胶囊与复方天仙胶囊对原发性肝癌９３例的临床疗效，结果表明：乾坤宁治疗组总有效率为３６．８４％，复方天仙组为３８．８８％。两组总有效率、总显效率及主要症状疗效比较均无统计学意义（Ｐ＞０．０５）。治疗组ＡＦＰ治疗前后比较有统计学意义（Ｐ＜０．０５）。提示乾坤宁胶囊对原发性肝癌有一定疗效     

我国人体首次发现圆圃棘口吸虫病例及虫体形态观察

1988年7月6日,我们在一患者便内发现似姜片虫卵的大型虫卵。临床表现为头昏无力、食欲不振,上腹痛和贫血。因病人20天前有吞食活泥鳅史,故疑其为棘口吸虫病。服药后获虫体70条,经形态学研究,鉴定为圆圃棘口吸虫(Echinostoma hortense Asada,1926)。     

Site-specific homologous recombination mutagenesis in group B streptococci

We describe the use of suicide vectors to generate site-specific mutations in group B streptococcus. This is accomplished by cloning gene-specific sequences into a temperature sensitive plasmid and selecting for clones which have undergone homologous recombination. The recombinan clones can be easily isolated by selecting for clones which have retained the antibiotic resistance markers that are present on the vector or cloned into the gene-specific sequences. To confirm the fidelity of the recombination events, PCR analysis is performed on chromosomal DNA isolated from the recombinant clones. Using this strategy, we have generated site- specific insertions in several capsule genes and have found that these insertions occurred as expected and that the mutations result in loss of capsule expression. In this report, we specifically detail the construction of cpsB mutants by single and double cross-over recombination and demonstrate that the resulting strains are acapsular.     

化瘀解毒汤对肾间质纤维化大鼠细胞外基质的作用

目的探讨化瘀解毒汤对肾间质纤维化大鼠细胞外基质(ECM)作用.方法采用单侧输尿管梗阻(UUO)法诱导肾间质纤维化动物模型,以免疫组织化学方法检测大鼠肾间质组织4种ECM成分(FN及Ⅰ、Ⅲ、Ⅳ型胶原),并作统计学分析,且作相关肾组织学检查.结果模型组及各治疗组大鼠4种ECM成分面积比较正常对照组明显增加(P＜0.05).;各治疗组大鼠ECM面积比较模型组明显减少(P＜0.05);各治疗组中中药预防组大鼠ECM面积比最低(P＜0.05);中药低剂量组大鼠ECM面积比最高(P＜0.05);中药高剂量组、苯那普利组大鼠ECM面积比无统计学差异(P＞0.05).各治疗组大鼠肾组织学检查较模型组有改善.结论化瘀解毒汤可抑制肾间质ECM的增生和积聚,防止肾间质的纤维化.     

复方补血胶囊中葡萄糖酸亚铁的含量测定

目的：复方补血胶囊中葡萄糖酸亚铁的含量测定。方法：根据Fe^2 与邻二氮菲显色,在510nm处有最大吸收,利用分光光度法测定。结果：葡萄糖亚铁在7－34μg/ml的浓度范围内线性关系良好（r=0.9999),回收率、日内变异均符合要求,结论：建立了复方补血胶囊中葡萄糖酸亚铁的含量测定方法。     

肛周坏死性筋膜炎术后热毒炽盛期应用解毒消痈饮的疗效观察

[目的] 探讨解毒消痈饮治疗肛周坏死性筋膜炎术后热毒炽盛期的临床效果。[方法] 将60例肛周坏死性筋膜炎患者随机分为对照组和观察组,各30例。对照组采用术后对症支持的常规治疗+痛痒消洗剂坐浴,观察组在对照组的基础上,术后口服解毒消痈饮治疗。[结果] 观察组治疗后第3、7、14天视觉模拟评分量表（VAS）评分均低于对照组,差异具有统计学意义（P<0.05）;两组治疗14 d后白细胞（WBC）、C-反应蛋白（CRP）、白细胞介素-6（IL-6）较治疗前显著减低,且观察组明显低于对照组（P<0.05）,而血红蛋白（Hb）较治疗前明显升高,且观察组优于对照组（P<0.05）;两组治疗14 d后坏死性筋膜炎实验室风险指数评分（LRINEC）、Fournier坏疽严重程度指数（FGSI）均较治疗前显著减低,且观察组明显低于对照组（P<0.05）;观察组治疗后第7、14天创面渗液和创面水肿情况评分均低于对照组,差异具有统计学意义（P<0.05）;观察组创面愈合时间较对照组短（P<0.05）;观察组的总有效率优于对照组（P<0.05）。[结论] 肛周坏死性筋膜炎术后热毒炽盛期应用解毒消痈饮疗效确切,能够有效缓解术后疼痛,降低炎症反应,提高血红蛋白含量,有利于评估患者术后病情及预后,减轻术后创面渗液和创面水肿,加速创面愈合。