Impact of chymotrypsin, N-acetylcysteine and chain protease on image visibility in upper gastrointestinal endoscopy / 中国内镜杂志

Objective?To compare the effect of chymotrypsin, N-acetylcysteine and chain protease on the image visibility before upper gastrointestinal endoscopy.?Methods?The patients who underwent painless gastroscopy from January 2016 to July 2016 were divided into four groups before gastroscopy. Group A is the control group (simethicone 600 mg + NaHCO3 2 g). Group B is the chymotrypsin group (simethicone 600 mg + chymotrypsin 200 u + NaHCO3 2 g). Group C is the N-acetylcysteine group (simethicone 600 mg + N-acetylcysteine 600 mg+ NaHCO3 2 g). Group D is the chain protease group (simethicone 600 mg + chain protease 20 000 u + NaHCO3 2 g). The corresponding drug is diluted in 100 ml of normal saline. Each group of patients was required to oral the diluted solution 30 minutes before gastroscopy. All patients’ gastroscopies were completed by one endoscopist, and each patient’s endoscopic image visibility were evaluated by the other two endoscopists. The three endoscopists were unaware of grouping. Each group chose 54 patients diagnosed with chronic gastritis to conduct a retrospective study. The total patients were 216. The total scores of image visibility, the washing time and the incidence of complications were compared and analyzed.?Results?The total image scores of group A, B, C and D were (32.19 ± 3.06), (36.64 ± 3.18), (39.03 ± 3.69) and (39.89 ± 3.35), respectively. Group A was the lowest (P < 0.05), followed by group B (P < 0.05). The total scores of group C and D were higher, and there was no difference between groups (P > 0.05). The washing time of each group were (42.00 ± 21.67) s, (17.78 ± 13.39) s, (12.32 ± 11.08) s and (11.98 ± 10.04) s. Group A was the longest (P < 0.05), while there were no significant differences among group B, C and D (P > 0.05). There were no significant differences in adverse effects among groups after upper gastrointestinal endoscopy.?Conclusion?Before conducting upper gastrointestinal endoscopy, simethicone in combination with chymotrypsin, N-acetylcysteine and chain protease can safely and effectively improve the visibility of endoscopic images and shorten the washing time. There is no obvious adverse reactions. N-acetylcysteine group and the chain protease group have the best effect, and the two effects are similar. So simethicone in combination with N-acetylcysteine or chain protease can be more effective in enhancing gastroscopic image visibility, shorter washing time, which can improve the detection rate of early lesions. When the clinical use of N-acetylcysteine and chain protease is limited, the use of chymotrypsin can also be considered to improve the visibility of endoscopic images.

Proton magnetic resonance spectroscopy in the evaluation of infiltration zone of cerebral alveolar echinococcosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Cerebral alveolar echinococcosis (CAE) grows infiltratively like a malignant tumor, causing great harm to the human body. It is possible to display mass lesions of CAE using various imaging systems, but regarding the infiltrating proliferation active regions, it is difficult to evaluate its actual range using conventional magnetic resonance imaging (cMRI). This research focused on proton magnetic resonance spectroscopy ((1)HMRS) techniques to find the mass and infiltration zone of CAE. We explored the marginal zone (MZ) of CAE nearly close to the actual infiltrating scope, to provide reliable images for clinical purposes, to overcome shortcomings of cMRI, to formulate beneficial clinical surgical plans and assess prognosis.</p><p><b>METHODS</b>Between September 2005 and May 2011, 15 patients who were suffering from CAE (36 effective lesions altogether) were examined by (1)HMRS at the first affiliated hospital of Xinjiang Medical University. Multi-voxel (1)HMRS was acquired with a 1.5T MRI scanner. Concentrations and the ratios of the metabolites of CAE were calculated. Furthermore, changes in the concentrations of the metabolites containing N-acetyl-aspartic-acid (NAA), choline (Cho), creatine (Cr), lipids and lactate (Lip + Lac) and the ratios of Cho/Cr, NAA/Cr, (Lip + Lac) /Cr were compared in the substantial region, 0 - 10 mm MZ, and 11 - 20 mm MZ of the infiltration zone, as well as the corresponding contralateral part of the normal brain parenchyma area (control group).</p><p><b>RESULTS</b>In this study, the ratios of Cho/Cr in the substantial region, 0 - 10 mm MZ of infiltration zone and the control group were 1.78 ± 0.70, 1.90 ± 0.54, and 0.78 ± 0.15, respectively; the ratios of NAA/Cr were 1.60 ± 0.20, 1.80 ± 0.42, 2.24 ± 0.86, respectively; the ratios of (Lip + Lac)/Cr were 25.69 ± 13.84, 25.18 ± 16.03, and 0.61 ± 0.15, respectively. From the control group, 11 - 20 mm MZ to 0 - 10 mm MZ and the substantial region of CAE, the concentrations of the metabolites showed that NAA and Cho decreased gradually and markedly. But (Lip + Lac) increased gradually and markedly. The ratios of Cho/Cr and NAA/Cr, (Lip + Lac)/Cr were statistically significant (P < 0.0083) between the substantial region and the control group, as well as between the 0 - 10 mm MZ and the control group. The ratios of Cho/Cr and NAA/Cr, (Lip + Lac)/Cr displayed no statistically significant differences (P > 0.0083) between the substantial region and the 0 - 10 mm MZ.</p><p><b>CONCLUSIONS</b>There was a pathological spectrum surrounding the infiltration zone of CAE. Multi-voxel 1HMRS has great clinical value for discerning the main lesion and the infiltration zone of CAE.</p>

Clinical study on the treatment of acromioclavicular joint dislocation of tossy grade III with double endobutton / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effects of internal fixation with double endobutton for the treatment of acromioclavicular joint dislocation of Tossy Grade III.</p><p><b>METHODS</b>From 2007.7 to 2008.12, 27 patients with acromioclavicular joint dislocation of Tossy Grade III were fixed with double endobutton. Among the patients, 17 patients were male and 10 patients were female, with an average age of (35.0 +/- 1.3) years (ranged from 23 to 60 years). Fourteen patients were injured by traffic accident, 6 patients were work-related injuries, 4 patients were sports injuries, and 3 patients were injured by falling down. Sixteen patients had injuries in the left, and 11 patients in the right. All the patients were Tossy III type dislocation without clavicle fracture. The therapeutic effects were evaluated by Karlsson criteria based on range of motion of acromioclavicular joint, pain, muscle force and postreduction X-ray.</p><p><b>RESULTS</b>All the patients were followed up for 6 to 14 months, mean 10.2 months. According to the Karlsson score criteria, 24 patients obtained an excellent result, 2 fair and 1 poor.</p><p><b>CONCLUSION</b>Fixation with double endobutton is to be a new method for the treatment of acromioclavicular joint dislocation, which has the advantages of minimal trauma, reliable fixation, early functional rehabilitation and so on.</p>

Controlled clinical trials on the Pizhen and massage for the treatment of thoracic lateral cutaneous nerve entrapment syndrome / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effects of Pizhen for the treatment of thoracic lateral cutaneous nerve entrapment syndrome.</p><p><b>METHODS</b>From March 2004 to April 2008, among the 320 patients with thoracic lateral cutaneous nerve entrapment syndrome, 160 patients (105 patients were male and 55 patients were female, ranging in age from 26 to 66 years, with an average of 46.00 +/- 0.79 years) were treated with Pizhen for 3 to 7 days, and 160 patients (98 patients were male and 62 patients were female, ranging in age from 19 to 64 years,with an average of 47.00 +/- 0.35 years) were treated with massage for 1 to 2 months. The therapeutic effects of the two groups were compared based on changes of tension test of local soft tissues, local pain and tenderness.</p><p><b>RESULTS</b>All the patients were followed up and the duration ranged from 7 to 12 months, averaged in 10.3 months. Among the patients in Pizhen group, 119 patients got an excellent result, 27 good, 12 fair, and 2 poor, and the tension test of local soft tissues decreased from preoperative (3.68 +/- 0.28) to postoperative (2.13 +/- 0.35). In the control group, 73 patients got an excellent result, 38 good, 40 fair, and 9 poor, the tension test of local soft tissues decreased from preoperative (3.59 +/- 0.22) to postoperative (3.17 +/- 0.19). The therapeutic effects and tension test of local soft tissue in the two groups had statistical differences (P < 0.01). The therapeutic effects of Pizhen group was better than that of the control group, and the postoperative tension test of local soft tissues of patients in Pizhen group was lower than that of the control group.</p><p><b>CONCLUSION</b>The clinical effect of Pizhen is better than the massage for the treatment of thoracic lateral cutaneous nerve entrapment syndrome. The Pizhen is effective to decrease the pressure around nerve, relax the adhesion, so as to eliminate the stimulation and compression of sensory nerve endings to relieve the pain quickly. But massage need longer course of treatment. So Pizhen therapy is safe, good and easily to practice, which is better than massage therapy.</p>

Comparative study on the Pizhen and acupuncture for the treatment of supraclavicular nerve-entrapment syndrome / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effects of Pizhen for the treatment of supraclavicular nerve-entrapment syndrome.</p><p><b>METHODS</b>From March 2004 to April 2006, among the 200 patients of supraclavicular nerve-entrapment syndrome, 100 patients (75 patients were male and 25 patients were female, ranging in age from 25 to 65 years, with an average of 45 years)were treated with Pizhen, 100 patients (60 patients were male and 40 patients were female, ranging in age from 16 to 63 years, with an average of 35 years) were treated with Acupuncture. The therapeutic effects of the two groups were compared.</p><p><b>RESULTS</b>All the patients were followed up and the duration ranged from 6 to 12 months, 9.6 months in average. Among the patients in Pizhen group, 79 patients got an excellent result, 12 good, 8 fair, and 1 poor, and the tension exponent of soft tissues decreased from preoperative 3.56 +/- 0.35 to postoperative 2.11 +/- 0.41. In the control group, 43 patients got an excellent result, 21 good, 17 fair, and 19 poor, the tension exponent of soft tissues decreased from preoperative 3.61 +/- 0.21 to postoperative 3.13 +/- 0.56. The therapeutic effects and tension exponent of soft tissue in the two groups had statistical differences (P < 0.05 and P < 0.01).</p><p><b>CONCLUSION</b>The clinical effect of Pizhen is better than the the acupuncture for the treatment of supraclavicular nerve-entrapment syndrome. The therapy of Pizhen is safe, good and easily to practice.</p>