益肾活血胶囊对高同型半胱氨酸血症兔血液ET、NO、NOS的影响

[目的]探讨益肾活血胶囊对高同型半胱氨酸(Hcy)血症兔血液内皮素(ET)、一氧化氮(NO)、一氧化氮合成酶(NOS)的影响。[方法]40只新西兰兔,随机平分为正常组、模型组、益肾活血胶囊小剂量组、益肾活血胶囊大剂量组及西药组(叶酸、维生素B6、维生素B12),除正常组外,其他组建立高Hcy血症及动脉粥样硬化(AS)动物模型,然后分别给予相应的药物治疗。高效液相色谱技术检测血浆Hcy浓度,放免法测定血浆ET浓度,硝酸还原酶法测定血清NO含量及总NOS活力。[结果]益肾活血胶囊大剂量组与模型组对照,血浆Hcy为(19.76±1.74)μmol/L、(32.12±5.29)μmol/L,血浆ET为(188.41±4.94)pg/ml、(280.41±17.490)pg/ml,血清NOS为(10.90±0.71)U/ml、(5.32±0.96)U/ml,血清NO为(126.39±15.99)μmol/L、(55.81±4.95)μmol/L)。[结论]益肾活血胶囊可明显降低血浆Hcy水平,抑制Hcy诱导的动脉粥样硬化形成,其机制可能与减轻血管内皮功能损伤有关。     

Double-balloon enteroscopy for obscure gastrointestinal bleeding: A single center experience in China

AIM: To evaluate the diagnostic value of double-balloon enteroscopy (DBE) for obscure gastrointestinal bleeding (OGIB). METHODS: The data about 75 OGIB patients who underwent DBE in January 2007-June 2009 in our hospital were retrospectively analyzed. RESULTS: DBE was successfully performed in all 75 patients without complication. Of the 75 patients, 44 (58.7%) had positive DBE findings, 22 had negative DBE findings but had potential bleeding at surgery and capsule endoscopy, etc . These 66 patients were fi...     

Meta-analysis of capsule endoscopy in patients diagnosed or suspected with esophageal varices

The PillCam ESO(Given Imaging,Israel) or esophageal capsule endoscopy(ECE) is a novel technique used in the diagnostic evaluation of esophagus.Many studies have been performed to compare the accuracy of ECE against the current gold standard esophagogastro-duodenoscopy and a meta-analysis recently published by Lu et al suggests that ECE may have an acceptable sensitivity and specificity in detecting esophageal varices.We would like to discuss the importance and implication of publication bias in this meta-an...     

扭动超声乳化加囊膜染色在成熟期白内障摘除术的疗效观察

目的观察扭动超声乳化加囊膜染色在成熟期白内障摘出术中的应用。方法将80例（128眼）成熟期白内障患者随机分为A、B两组,其中A组40例（66眼）行扭动超声乳化白内障摘除术。B组40例（62眼）行传统超声乳化白内障摘除术,术中采用吲哚青绿行前囊染色后撕囊,术中观察前房稳定性,能量释放及时间,术后第1、3、7天观察角膜水肿、前房反应和视力情况。跟踪角膜内皮细胞变化。结果术中连续环形撕囊（CCC）成功率为96.8%,A组前房稳定性优于B组（〈0.05）;术中能量使用及超声时间明显少于B组,术后第1、3、7天时A组角膜水肿情况明显少于B组（〈0.05）;术后第1、3天A组视力恢复明显好于B组（〈0.05）。结论扭动超声乳化加囊膜染色在成熟期白内障摘除术应用是安全且高效、疗效好的手术方式,尤其对于成熟期中硬核白内障的处理,优于传统超声乳化白内障摘出术。     

胶囊内镜对慢性腹痛的诊断分析

目的分析胶囊内镜在慢性腹痛中的诊断价值。方法 2008年9月-2009年7月慢性腹痛25例、无消化道症状体检20例进行胶囊内镜检查,对诊断结果进行相关统计学分析。结果胶囊内镜均顺利完成检查,全部胶囊在检查结束后排出体外。检查过程中患者无任何不适。慢性腹痛患者中,小肠溃疡3例（12%）,小肠息肉3例（12%）,十二指肠扭转1例（4%）,空肠静脉瘤1例（4%）,空肠蛔虫病1例（4%）,回肠黏膜糜烂1例（4%）。无消化道症状的体检者中,小肠息肉2例（10%）,回肠黏膜糜烂1例（5%）。小肠疾病在慢性腹痛患者中检出率40%,明显高于无消化道症状的体检者（15%）,两者比较有统计学意义（P〈0.01）。两组的胃排空时间分别为（40.99±31.38）min和（37.90±24.89）min,到达回盲部时间分别为（220.89±91.64）min和（225.68±80.59）min,两组比较无统计学意义（P〉0.05）。结论胶囊内镜在慢性腹痛的诊断中有良好价值,临床安全性好。     

Capsule endoscopy:Current practice and future directions

Capsule endoscopy(CE)has transformed investigation of the small bowel providing a non-invasive,well tolerated means of accurately visualising the distal duodenum,jejunum and ileum.Since the introduction of small bowel CE thirteen years ago a high volume of literature on indications,diagnostic yields and safety profile has been presented.Inclusion in national and international guidelines has placed small bowel capsule endoscopy at the forefront of investigation into suspected diseases of the small bowel.Most commonly,small bowel CE is used in patients with suspected bleeding or to identify evidence of active Crohn’s disease(CD)(in patients with or without a prior history of CD).Typically,CE is undertaken after upper and lower gastrointestinal flexible endoscopy has failed to identify a diagnosis.Small bowel radiology or a patency capsule test should be considered prior to CE in those at high risk of strictures(such as patients known to have CD or presenting with obstructive symptoms)to reduce the risk of capsule retention.CE also has a role in patients with coeliac disease,suspected small bowel tumours and other small bowel disorders.Since the advent of small bowel CE,dedicated oesophageal and colon capsule endoscopes have expanded the fields of application to include the investigation of upper and lower gastrointestinal disorders.Oesophageal CE may be used to diagnose oesophagitis,Barrett’s oesophagus and varices but reliability in identifying gastroduodenal pathology is unknown and it does not have biopsy capability.Colon CE provides an alternative to conventional colonoscopy for symptomatic patients,while a possible role in colorectal cancer screening is a fascinating prospect.Current research is already addressing the possibility of controlling capsule movement and developing capsules which allow tissue sampling and the administration of therapy.     

银杏叶提取物对牙龈卟啉单胞菌的体外抑菌作用

目的：探讨银杏叶提取物对牙龈卟啉单胞菌的体外抑菌活性,为研制开发治疗牙周病的新型纯中药抗菌药物提供药理学依据。方法：本实验分为阴性对照组、亚胺培南对照组和不同浓度及剂型的银杏叶提取物组。采用溶剂提取法制取银杏叶提取物,采用打孔法和试管法在厌氧环境下检测银杏叶提取物对牙龈卟啉单胞菌的体外抑菌活性,并与金黄色葡萄球菌和大肠埃希菌对比。通过观察抑菌环直径和测定最小抑菌浓度（MIC）衡量银杏叶提取物的体外抑菌作用。结果：在抑菌环实验中,银杏叶提取物、银杏叶片和银杏叶软胶囊的原液和1∶4的稀释液作用于牙龈卟啉单胞菌,抑菌环直径随着浓度的降低而减小,银杏叶提取物的最大抑菌直径为16.5 mm,银杏叶片和软胶囊最大抑菌直径分别为15.3和14.5 mm,银杏叶提取物抑菌直径明显大于银杏叶片和银杏叶软胶囊（P <0.05）,银杏叶片与银杏叶软胶囊抑菌直径比较差异无统计学意义（P>0.05）;大肠埃希菌组和金黄色葡萄球菌组得到同样的结果。MIC测定,银杏叶提取物组内比较,银杏叶提取物浓度高于1.95 mg/L时,试管内均无牙龈卟啉单胞菌生长,而大肠埃希菌和金黄色葡萄球菌仍可以生长,浓度高于6.25和12.5 mg/L时大肠埃希菌和金黄色葡萄球菌不生长,银杏叶提取物对牙龈卟啉单胞菌的抑菌作用优于大肠埃希菌和金黄色葡萄球菌。结论：银杏叶提取物对牙龈卟啉单胞菌具有抑菌作用。     

Safety and utility of capsule endoscopy for infants and young children

AIM:To assess the safety and utility of capsule endoscopy(CE)for children who are unable to swallow the capsule endoscope.METHODS:The medical records of all of the children who underwent CE between 2010 and 2012 were retrospectively reviewed.The patients were divided into 2groups:group A included patients who were unable to swallow the capsule endoscope,and group B included patients who were able to swallow it.For the patients who were unable to swallow the capsule endoscope,it was placed in the duodenum endoscopically.The small bowel transit time,endoscopic diagnosis and complications of the 2 groups were compared.RESULTS:During the study period,28 CE procedures were performed in 26 patients.Group A included 11patients with a median age of 2 years(range 10 mo-9years),and group B included 15 patients with a median age of 12 years(range 8 years-16 years).The lightest child in the study weighed 7.9 kg.The detection rates did not differ between the 2 groups.The median small bowel transit time was 401 min(range 264-734 min)in group A and 227 min(range 56-512 min)in group B(P=0.0078).No serious complications,including capsule retention,occurred.No significant mucosal trauma occurred in the pharynx,esophagus,stomach or duodenum when the capsule was introduced using an endoscope.CONCLUSION:CE is a safe and useful procedure for infants and young children who are unable to swallow the capsule endoscope.     

Screening pre-bariatric surgery patients for esophageal disease with esophageal capsule endoscopy

AIM:To determine if esophageal capsule endoscopy(ECE)is an adequate diagnostic alternative to esophagogastroduodenoscopy(EGD)in pre-bariatric surgery patients.METHODS:We conducted a prospective pilot study to assess the diagnostic accuracy of ECE(PillCam ESO2,Given Imaging)vs conventional EGD in pre-bariatric surgery patients.Patients who were scheduled for bariatric surgery and referred for pre-operative EGD were prospectively enrolled.All patients underwent ECE followed by standard EGD.Two experienced gastroenterologists blinded to the patient’s history and the findings of the EGD reviewed the ECE and documented their findings.The gold standard was the findings on EGD.RESULTS:Ten patients with an average body mass index of 50 kg/m2were enrolled and completed the study.ECE identified 11 of 14(79%)positive esophageal/gastroesophageal junction(GEJ)findings and 14of 17(82%)combined esophageal and gastric findings identified on EGD.Fisher’s exact test was used to compare the findings and no significant difference was found between ECE and EGD(P=0.64 for esophageal/GEJ and P=0.66 for combined esophageal and gastric findings respectively).Of the positive esophageal/GEJ findings,ECE failed to identify the following:hiatal hernia in two patients,mild esophagitis in two patients,and mild Schatzki ring in two patients.ECE was able to identify the entire esophagus in 100%,gastric cardia in0%,gastric body in 100%,gastric antrum in 70%,pylorus in 60%,and duodenum in 0%.CONCLUSION:There were no significant differences in the likelihood of identifying a positive finding using ECE compared with EGD in preoperative evaluation of bariatric patients.     

Double-balloon enteroscopy for mesenchymal tumors of small bowel:Nine years’ experience

AIM:To assess the value of double-balloon enteroscopy(DBE) for the diagnosis of gastrointestinal mesenchymal tumors(GIMTs) in the small bowel and clarify their clinical and endoscopic characteristics.METHODS:A retrospective review in a total of 783 patients who underwent a DBE procedure from January 2003 to December 2011 was conducted.Data from patients with pathologically confirmed GIMTs were analyzed at a single tertiary center with nine years’ experience.The primary outcomes assessed included characteristics of patients with GIMTs,indications for DBE,overall diagnostic yield of GIMTs,endoscopic morphology,positive biopsy,comparison of diagnosis with capsule endoscopy,and subsequent interventional management.RESULTS:GIMTs were identified and analyzed in 77 patients.The mean age was 47.74 ± 14.14 years(range:20-77 years),with 63.6% being males.The majority of individuals presented with gastrointestinal bleeding,accounting for 81.8%,followed by abdominal pain,accounting for 10.4%.Small bowel pathologies were found in 71 patients,the detection rate was 92.2%.The diagnostic yield of DBE for GIMTs was 88.3%.DBE was superior to capsule endoscopy in the diagnosis of GIMTs(P = 0.006;McNemar’s χ2 test).Gastrointestinal stromal tumor was the most frequent and leiomyoma was the second frequent GIMT.Single and focal lesions were typical of GIMTs,and masses with smooth or unsmooth surface were the most common in the small bowel.GIMTs were removed from all the patients surgically except one patient treated with endoscopic resection.CONCLUSION:DBE is a safe and valuable procedure for patients with suspected GIMTs,and it provides an accurate position for subsequent surgical intervention.