A review of image-enhanced endoscopy in the evaluation of colonic polyps

The practice of colonoscopy has changed considerably over the last decade. The growth of image-enhanced endoscopy have altered our concepts of how we perform colonoscopy. This article examines the evidence base behind these techniques and looks at where future research needs to be directed.     

青黛新三萜物质合剂抗高危HPV病毒临床疗效观察

目的观察青黛新三萜物质合剂抗高危HPV病毒的治疗效果及其在预防宫颈癌病变发展中的作用。方法高频超声提取青黛新三萜物质,将其与枯矾、冰片联合制成合剂,观察其抗高危HPV病毒效果及对宫颈上皮内瘤变(CIN)及宫颈糜烂治疗的有效率并与干扰素对比。结果青黛新三萜物质合剂组及干扰素组治疗3月后HPV-DNA转阴率分别为87.5%、71.4%,对CIN治疗有效率分别为75.0%、44.0%,对宫颈糜烂治疗有效率90.6%、47.1%。青黛新三萜物质合剂组高危HPVDNA转阴患者,治疗结束后3个月、6个月、12个月再复查高危HPV-DNA均为阴性。结论青黛新三萜物质合剂是抗高危HPV病毒安全有效的中药制剂,它在预防宫颈癌的发生、治疗宫颈糜烂方面有确切的临床价值。     

Comparison of ozone-specific (OZAC) and oxygen radical (ORAC) antioxidant capacity assays for use with nasal lavage fluid

Antioxidants in respiratory mucus protect the underlying airway epithelium from damage by ozone (O₃), a common outdoor air pollutant. To understand O₃–antioxidant interactions and the variation of these interactions among individuals, in vitro assays are needed to measure the total antioxidant capacity of airway lavage fluid, a convenient source of (diluted) mucous samples. Here, we compare the oxygen radical absorbance capacity (ORAC), a general method that uses peroxyl radicals as a reactive substance, to the recently developed ozone specific antioxidant capacity (OZAC), a procedure that directly employs O₃. For prepared model mucous antioxidant solutions containing uric acid, ascorbic acid or glutathione, the ORAC and OZAC methods yielded comparable antioxidant capacities. The addition of EDTA or DETAPAC, necessary to prevent auto-oxidation of test solutions during the ORAC assay, unpredictably altered ORAC measurements. EDTA did not have a significant effect on OZAC measurements in either prepared uric acid or ascorbic acid solutions. When assessing antioxidant capacities of nasal lavage samples, the ORAC and OZAC assays were no longer comparable. Because the OZAC of nasal lavage samples was positively related to measured uric acid concentrations whereas the ORAC data were not, the OZAC method appears to provide more realistic mucous antioxidant capacities than the ORAC method.     

HPLC 法测定口腔溃疡含片（散）中靛蓝和靛玉红的含量

目的 优化样品处理过程,建立口腔溃疡含片(散)中同时测定靛蓝和靛玉红含量的方法。方法 以N,N-二甲基甲酰胺为溶剂,进行超声提取;色谱柱:Welch C₁₈(250 mm×4.6 mm,5 μm);流动相:甲醇—0.02%磷酸溶液(65∶35),流速:1 mL·min-1,检测波长:289 nm,柱温35℃。结果 靛蓝在69.12～1 728 ng范围内线性关系良好(r=0.999 5),含片和散剂中靛蓝平均回收率分别为102.6%,RSD=1.0% (n=6)和96.6%,RSD=1.3% (n=6),靛玉红在19.44～486 ng范围内线性关系良好(r=0.999 5),含片和散剂中靛玉红平均回收率分别为102.3%,RSD=2.3% (n= 6)和101.5%,RSD=2.1% (n=6)。结论 该方法准确、重现性好,并且可以同时测定靛蓝和靛玉红的含量,可用于口腔溃疡系列制剂中青黛的质量控制。     

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。     

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.     

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。     

青黛治疗溃疡性结肠炎的机制研究进展

溃疡性结肠炎(ulcerative colitis,UC)是一种与自身免疫相关的慢性非特异性肠道炎症性疾病,中医认为UC的病理性质为本虚标实,病理因素主要包括湿、热、瘀、毒等,青黛有清热解毒、凉血消斑之效,作为复方制剂的重要成分之一,被长期用于UC的口服或局部治疗中。近年来研究者采用青黛单药及其主要成分口服或纳肛治疗UC亦取得良好效果,并针对其作用机制开展了大量研究。本文主要归纳总结了近年来青黛及其有效成分提取物(靛玉红、靛蓝、色胺酮)等治疗UC的机制研究。     

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。