The Diagnosis of Gastroesophageal Reflux Disease

Background

Gastroesophageal reflux disease is a highly prevalent condition that imposes a significant economic impact on the US health care system. The utility of commonly used tests for the diagnosis of gastroesophageal reflux disease has not been adequately reviewed.

Methods

A comprehensive review of the literature was undertaken to provide an evidence-based approach to the diagnosis of gastroesophageal reflux disease. EMBASE (1980-December 2008), OVID MEDLINE, and PubMed, (1966-December 2008) were searched using “gastroesophageal reflux” and “adults” with other terms, including medications, diagnostic tests, symptoms, and epidemiologic terms. Studies were limited to human trials, English language, and full articles.

Results

Heartburn is a reasonably sensitive symptom for the diagnosis of gastroesophageal reflux disease, although it does not reliably predict esophagitis. Standardized questionnaires have limited specificity, whereas the double-contrast barium swallow has a low sensitivity to diagnose gastroesophageal reflux. The role of esophageal manometry is limited to accurate placement of a pH-measuring device. pH testing has reasonable sensitivity and specificity for the diagnosis of gastroesophageal reflux disease. The sensitivity of upper endoscopy to diagnose gastroesophageal reflux is lower than that of pH tests.

Conclusion

The diagnosis of gastroesophageal reflux disease remains difficult. In the absence of alarm symptoms, empiric treatment with acid suppression is warranted. pH testing provides valuable information in many patients, although the clinical utility of newer tests needs to be determined. Endoscopy should not be the first test used to diagnose gastroesophageal reflux.     

慢性输卵管炎致不孕90例治疗体会

目的：探讨口服金刚腾胶囊结合输卵管通液术治疗隧性输卵管炎致不孕的价值。方法：对某院近5年门诊治疗慢性输卵管炎不孕90例归纳总结。结果：对慢性输卵管炎性不孕,口服金刚腾胶囊结合输卵管通液术较输卵管通液术结合用抗生素治疗有明显优势,受孕率明显提高。结论：中药金刚腾对治疗慢性输卵管炎致不孕有明显疗效。     

芍石护睛胶囊中芍药苷的含量测定及其初步稳定性研究

目的:测定芍石护睛胶囊中芍药苷的含量,并对其初步稳定性进行研究,以确定该制剂的有效期。方法:采用高效液相色谱法测定,色谱柱为Hypersil C18(250mm×4.6mm,5μm),流动相为甲醇-水(23∶73),流速为1.0mL.min-1,柱温为30℃,检测波长为230nm。结果:芍药苷进样量在0.074 05～0.740 5μg范围内与峰面积积分值呈良好的线性关系(r=0.999 9);平均回收率为100.67%,RSD=2.0%(n=6)。芍石护睛胶囊有效期暂定为2年。结论:本方法简单、易行,可用于芍石护睛胶囊的质量控制。     

肝康灵胶囊对化疗药物的增效减毒作用研究

目的:研究肝康灵胶囊(GKL)对化疗药物的增效减毒作用。方法:以体内抑瘤实验测定GKL单独使用及与顺铂(DDP)伍用时对小鼠移植性肿瘤(S180肉瘤、H22肝癌和Lewis肺癌肿瘤)的抑癌率,并考察GKL分别与DDP和丝裂霉素(MMC)伍用时对荷瘤小鼠白细胞数、免疫器官质量、巨噬细胞吞噬功能和自然杀伤(NK)细胞活性的影响。结果:GKL对小鼠移植性肿瘤(S180肉瘤、H22肝癌和Lewis肺癌肿瘤)均有抑制作用;当其分别与MMC和DDP伍用时,能显著提高2种化疗药物的抑癌率(P<0.01);GKL还可显著减少MMC和DDP所致小鼠白细胞下降、免疫器官萎缩、巨噬细胞吞噬功能下降和NK细胞活性降低等副作用。结论:GKL具有显著的抗肿瘤和增效减毒作用。     

蛞蝓胶囊致畸和致突变实验研究

目的探讨蛞蝓胶囊是否具有致畸和致突变的毒理作用。方法本研究采用大鼠致畸胎、艾姆斯（Ames）试验、小鼠骨髓细胞微核试验、体外细胞染色体畸变试验检测的蛞蝓胶囊致畸胎、致突变性。结果蛞蝓胶囊各剂量对孕鼠体重、胚胎早期发育、胚胎生长发育、以及胎鼠的骨骼发育和内脏器官发育等均无不良影响。无论加与不加S9,各剂量组诱变TA98、TA100种菌落数均未超过自然回变菌落数,与阴性对照组比较均无显著性差异（P〉0．05）。与对照组相比,各剂量组对小鼠的微核率无明显的影响（P〉0．05）。蛞蝓胶囊对培养的哺乳动物体细胞染色体结构无致畸变作用。结论蛞蝓胶囊各剂量均无致畸和致突变的作用,说明在临床应用剂量范围内是安全的。     

杏香兔耳风片联合射频热消融治疗重度宫颈糜烂的疗效观察

目的评价杏香兔耳风片联合射频热消融治疗重度宫颈糜烂的临床疗效。方法选取160例重度宫颈糜烂患者,随机分为治疗组和对照组,各80例。对照组：予以射频消融治疗。治疗组：在射频热消融治疗前后加用杏香兔耳风片。结果治疗组、对照组治愈率分别为92．5％、76．25％,2组有显著性差异（P〈0．01）。治疗组术后阴道排液时间及出血时间均少于对照组,2组有显著性差异（P〈0．05）。结论杏香兔耳风片联合射频热消融治疗重度宫颈糜烂疗效肯定、并发症轻,是一种值得推广的治疗方法。     

重组人干扰素a-2b栓的质量研究和稳定性研究

目的本次试验研究的目的是将重组人干扰素α-2b制备成通过直肠局部给药达到全身作用的栓剂。方法应用脂肪酸甘油酯suppcioreBM为基质,以Triton X-100为促吸收剂,制备重组人干扰素α-2b栓。以稳定性为指标,考察重组人干扰素α-2b栓的处方。结果用此方法制备的重组人干扰素α-2b栓稳定性强,在2～8℃条件下可保存24个月。结论重组人干扰素α-2b栓的应用可增强患者的顺应性,在临床中应用性强。