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Objective:To explore the influencing factors of the image cleanliness scores of magnetically-controlled capsule endoscopy (MCE) and the methods to improve cleanliness scores.Methods:Data of patients undergoing MCE from October 2017 to August 2020 in Peking University First Hospital were analyzed retrospectively. The cleanliness scores at six regions of the stomach (cardia, fundus, body, angularis, antrum, and pylorus) were recorded (1-4 points), and the sum of the scores from these six regions was also calculated. Clinical features [gender, age, body mass index, indication, use of esophagus cap, and medication of proton pump inhibitors(PPI)], and gastric preparation regimens (one dose of pronase: simethicone 5 mL + pronase 20 000 U + sodium bicarbonate 1 g; or two doses of pronase: simethicone 5 mL + pronase 40 000 U + sodium bicarbonate 2 g) were collected. Cleanliness scores were defined as poor (group P, total cleanliness scores≤18) and as good (group G, total cleanliness scores>18). Clinical features, indication, use of esophagus cap and PPI, and preparation regimes were compared. Factors influencing cleanliness scores were analyzed.Results:A total of 238 consecutive patients with median age of 61.5 (54.0, 76.3) years were recruited according to inclusion criteria, among whom 68(28.6%) were female. There were 35 patients (14.7%) in group P with median age of 67.0 (56.0, 83.0) years. There were 203 patients(85.3%)in group G with median age of 61.0 (53.0, 75.0) years. No significant differences were found in age, sex, body mass index or esophagus cap use( P>0.05). Indications of abdominal symptoms or digestive system diseases( OR= 2.899, 95% CI: 1.258-6.681, P=0.012) and PPI use ( OR=3.168, 95% CI: 1.261-7.959, P=0.014) were more likely to yield a low cleanliness score. Gastric preparation regimen with two doses of pronase ( OR=0.201, 95% CI: 0.067~0.603, P=0.004)was more likely to avoid a low cleanliness score. Conclusions:Indications of digestive system diseases or abdominal symptoms and PPI use may decrease the cleanliness scores of MCE, while gastric preparation with double doses of pronase may improve it.
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Objective@#To clarify the correlation between the clinical characteristics, esophageal motility features and esophageal acid exposure in patients with ineffective esophageal motility (IEM).@*Methods@#From January 2016 to March 2018, at Peking University First Hospital, 22 IEM patients diagnosed by esophagus high-resolution manometry (HRM) and 24 individuals with normal HRM results were enrolled. Clinical features, parameters of esophageal HRM and results of esophageal 24-hour pH monitoring of IEM patients and the individuals with normal HRM results were compared. According to the median distal contraction integral (DCI) of ten swallows, the IEM patients were divided into mild-IEM group (DCI 250-450 mmHg·s·cm (1 mmHg=0.133 kPa)) (14 cases) and severe-IEM group (DCI<250 mmHg·s·cm) (eight cases). The clinical features and esophageal motility were compared between normal HRM group, mild-IEM group and severe-IEM group. T test, chi-square test and one-way analysis of various were used for statistical analysis.@*Results@#The age of IEM group was older than that of normal HRM group ((64.5±11.2) years vs. (50.3±18.2) years), and the difference was statistically significant (t=-3.135, P=0.003). The lower esophageal sphincter pressure (LESP) of IEM group was lower than that of normal HRM group ((17.0±6.8) mmHg vs. (22.3±7.2) mmHg), and the difference was statistically significant (t=2.516, P=0.016). There were 15 cases in normal HRM group and 14 patients in IEM group who underwent esophageal 24-hour pH monitoring and there were five and two patients with abnormal acid exposure time (AET) in normal HRM group and IEM group, respectively. The length of proximal esophageal body (PEB) pressure zone of severe-IEM group was shorter than those of normal HRM group and mild-IEM group ((2.8±1.5) cm vs.(4.2±0.7) cm and (4.6±0.9) cm), and the differences were statistically significant (t=2.397 and 3.432, P=0.044 and 0.003). The integrated relaxation pressure (IRP) and LESP of normal HRM group were both higher than those of mild-IEM group ((9.3±2.9) mmHg vs. (7.2±3.3) mmHg, (22.3±7.2) mmHg vs. (15.4±7.1) mmHg), and the differences were statistically significant (t=2.148 and 2.843, P=0.038 and 0.007). There were six and eight patients in mild-IEM group and severe-IEM group who underwent esophageal 24-hour pH monitoring, respectively, and two patients in mild-IEM had abnormal AET.@*Conclusions@#The LESP of IEM patients is low. The clinical features and AET of IEM patients are not associated with the severity of IEM. In patients with severe IEM, the proximal and distal esophageal contractility is weakened, and the length of PEB pressure zone is shortened.
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Objective To clarify the correlation between the clinical characteristics,esophageal motility features and esophageal acid exposure in patients with ineffective esophageal motility (IEM). Methods From January 2016 to March 2018,at Peking University First Hospital,22 IEM patients diagnosed by esophagus high-resolution manometry (HRM ) and 24 individuals with normal HRM results were enrolled. Clinical features,parameters of esophageal HRM and results of esophageal 24-hour pH monitoring of IEM patients and the individuals with normal HRM results were compared. According to the median distal contraction integral (DCI)of ten swallows,the IEM patients were divided into mild-IEM group (DCI 250 - 450 mmHg · s · cm (1 mmHg = 0. 133 kPa))(14 cases)and severe-IEM group (DCI < 250 mmHg·s·cm)(eight cases). The clinical features and esophageal motility were compared between normal HRM group,mild-IEM group and severe-IEM group. T test,chi-square test and one-way analysis of various were used for statistical analysis. Results The age of IEM group was older than that of normal HRM group ((64. 5 ± 11. 2)years vs. (50. 3 ± 18. 2)years),and the difference was statistically significant (t = - 3. 135,P = 0. 003). The lower esophageal sphincter pressure (LESP)of IEM group was lower than that of normal HRM group ((17. 0 ± 6. 8)mmHg vs. (22. 3 ± 7. 2)mmHg),and the difference was statistically significant (t = 2. 516,P = 0. 016). There were 15 cases in normal HRM group and 14 patients in IEM group who underwent esophageal 24-hour pH monitoring and there were five and two patients with abnormal acid exposure time (AET)in normal HRM group and IEM group,respectively. The length of proximal esophageal body (PEB)pressure zone of severe-IEM group was shorter than those of normal HRM group and mild-IEM group ((2. 8 ± 1. 5 )cm vs. (4. 2 ± 0. 7 )cm and (4. 6 ± 0. 9)cm),and the differences were statistically significant (t = 2. 397 and 3. 432,P = 0. 044 and 0. 003). The integrated relaxation pressure (IRP)and LESP of normal HRM group were both higher than those of mild-IEM group ((9. 3 ± 2. 9 )mmHg vs. (7. 2 ± 3. 3 )mmHg,(22. 3 ± 7. 2 )mmHg vs. (15. 4 ± 7. 1)mmHg),and the differences were statistically significant (t = 2. 148 and 2. 843,P = 0. 038 and 0. 007). There were six and eight patients in mild-IEM group and severe-IEM group who underwent esophageal 24-hour pH monitoring,respectively,and two patients in mild-IEM had abnormal AET. Conclusions The LESP of IEM patients is low. The clinical features and AET of IEM patients are not associated with the severity of IEM. In patients with severe IEM,the proximal and distal esophageal contractility is weakened,and the length of PEB pressure zone is shortened.
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Data of patients with maxillofacial and jugular venous malformations involving isthmus faucium area from January 2012 to July 2016 were collected. Patients were questioned about the medical history before operation, and the airway was adequately evaluated. The patients diagnosed as having non-difficult airways were endotracheally tubed using fast induction of anesthesia. Tracheal intubation was per-formed using fast induction of anesthesia combined with topical anesthesia after visual laryngoscopy in the patients assessed as having difficult airways. Endotracheal intubation was guided with a visual hard endo-scope or a fibrobronchoscope in the patients with difficulty in opening mouth after multiple treatments. Post-operative airway management was as follows: the tracheal tube was removed after extubation, the tracheal tube was retained for 24-48 h, or preventive tracheotomy was performed. Oxygen was inhaled by mask. A total of 157 patients were included in this study, 55 patients diagnosed as having difficult airways, and a-mong the 55 patients, 87％ cases were intubated after visual laryngoscopy and 13％ cases received tracheot-omy. There were 10 patients with difficulty in opening mouth after multiple treatments and 5 cases under-went tracheotomy in the outer hospital. Sixteen patients presented with a transient increase in airway pres-sure during intraoperative injection of anhydrous ethanol. There were 106 cases in whom the tracheal tube was removed immediately after emergence, and among them, 32. 1％ cases needed tongue traction and 2. 8％ cases underwent emergency tracheotomy after extubation. Thirty-eight patients needed to retain the tracheal tube for 24-48 h after operation, and among them, 37％ cases needed tongue traction and 3％ ca-ses required emergency tracheotomy after extubation. Thirteen cases underwent preventive tracheotomy. The preoperative visit and assessment are especially important, appropriate airway management strategies should be developed, vital signs should be closely observed during operation, and the timing of extubation should be grasped for this type of patients, and the SpO2 and airway pressure should be mainly observed during op-eration especially for the patients who underwent anhydrous ethanol injection.
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Objective To evaluate the clinical performance of AQT90 FLEX,a novel time-resolved fluorescence based point-of-care test (POCT) for quantification of D-dimer in elderly patients.Methods The method from Quantitative D-dimer assay (WS/T 477-2015) for testing equipment performance was used as a reference to evaluate the clinical performance of AQT90 FLEX.The correlation was compared between testing results of D-dimer using the AQT90 immune-assay analyzer and those using the ACL TOP coagulation analyzer.Results At high concentration of D-dimer,the within-run precision coefficient of variation (CV)was 2.619％,and at low concentration of D-dimer,the within-run precision CV was 2.767％.The pollution-carrying rate was 0.12％.The measured data from AQT90 and ACL TOP had a correlation coefficient of r =0.9491 (P ＜ 0.01).The equation of the line of best fit for D-dimer with which all AQT90 results can be adapted to the ACL TOP was:AQT90 =2.52 ACL TOP + 0.15.The number from the equation was slightly greater in female than that in male,and it was also increased in elderly.Conclusions The AQT90 FLEX had rational precision and linearity in determination of concentration.There was a high agreement between the testing results from AQT90 and those from ACL TOP.It was recommended to use a slope of 2.52 and an intercept of 0.15 to adjust the D-dimer values of the ACL TOP to the AQT90 FLEX assay systems.POCT for D-dimer by AQT90 FLEX raises feasibility for use in elderly patients.
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Objective To establish a mouse model of bacterial vaginosis ( BV) by infecting estro-gen-treated mice with Prevotella bivia ( P. bivia) . Methods The mice were intraperitoneally injected with beta-estradiol 17 valerate which was suspended in sesame oil and then inoculated with different doses of P. bivia strains at the logarithmic phase. Samples of vaginal flushing fluid were collected at different time points after inoculation and used for the isolation of P. bivia strains and the detection of sialidase activities. Altogether 30 mice treated with estrogen and high dose of P. bivia were killed on days 2, 7 and 21 (n=10). Samples of cornua uteri, bladder and kidney were collected from those mice for P. bivia strains isolation. Re-sults Injection the estrogen-treated mice with P. bivia via vagina could cause the P. bivia infection for more than 14 days. The numbers of P. bivia strains isolated on day 21 decreased significantly. Enhanced sialidase activities and clue cells were observed in vaginal secretions of mice with P. bivia infection. Injection of mice with the high dose of P. bivia could spread the infection to cornua uteri. Conclusion Estrogen-treated mice could be used as an animal model for researches on BV.
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Objective To evaluate the relationship between severity of airway obstruction and peripheral arterial stiffness in patients with chronic obstructive pulmonary disease (COPD).Methods 81 COPD patients [aged (78.32 ± 6.98)yrs,73 males,8 females] from Jan 2008 to Oct 2012 were enrolledin Geriatric Department of Peking University First Hospital.All patients underwent spirometry and Holter evaluation,while age,sex,BMI,smoking pack-years,medical history,blood levels of lipid profiles,glucose,high sensitivity C reactive protein (hsCRP)and arterial oxygen pressure (PaO2)were recorded.The severity of airway obstruction was evaluated by spirometry.The patients were divided into two groups:mild/moderate group [forced expiratory volume in one second (FEV1％) predicted ≥ 50 ％,n=51] and severe group (FEV1％ predicted ＜ 50％,n=30).24-hour average heart rate (HR)was assessed by holter.Arterial stiffness was assessed by the brachial ankle pulse wave velocity (baPWV).The baPWV increment was considered to be a direct witness of arterial stiffness increase.Blood levels of lipid profiles,glucose,arterial oxygen pressure (PaO2)and hsCRP were compared between the two groups.Results Age,gender,smoking index,medical history of the two groups were matched.BMI was less in severe group than in mild/moderate group [(22.8± 4.2) kg/m2 vs.(25.3± 3.2) kg/m2,t=3.017,P＜0.05].24-hour average HR was higher in severe group than in mild/moderate group [(77.4± 12.7)bpm vs.(70.8± 9.6)bpm,t=-2.602,P＜0.05].The PaO2 was lower in severe group than in mild/moderate group [(74.6±13.0)mmHg vs.(82.4± 13.1)mmHg,t=2.456,P＜0.05].There were no differences in blood lipid profile and glucose levels between the two groups.76 patients (93.4％)were detected with peripheral arterial stiffness by baPWV＞14.00 m/s.baPWV was significantly increased in severe group as compared with mild/moderate group [(20.77 ± 3.71) m/s vs.(18.84 ± 1.88) m/s,t=-2.109,P＜0.05].hsCRP was significantly higher in severe group than in mild/moderate group [[(6.51±5.66)mg/L vs.(3.27±3.34)mg/L,t=-2.658,P＜0.01].Conclusions The morbidity of peripheral arterial stiffness is increased in patients with COPD.Progression of arterial stiffness is related to the severity of airway obstruction,which may be related to chronic inflammation,hypoxia,or excessive sympathetic activation.
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Objective To study the role of the outer membrane protein Rmp of Neisseria gonor-rhoeae strain in immunosuppression and the strategy of eliminating it .Methods The rmp gene of Neisseria gonorrhoeae strain was amplified by PCR and inserted into pMD 19-T vector .The recombinant vector pMD 19△rmp∷Kan containing Kan and the 5′-and 3′-flanking regions of rmp (△rmp∷Kan) was constructed by replacing 200 nucleotide residues of pMD 19-rmp with kanamycin resistance gene Kan and transformed into Neisseria gonorrhoeae WHO-A strain.PCR and Western blot assay were used to screen and identify the re-combinant mutant strains that could not express Rmp .Mice were immunized with mutant strains and bacteri-cidal activities of the immune sera were detected by antibody-mediated complement-dependent cytotoxicity assay.Results The mutant strains that could not encode Rmp were successfully constructed .Antibodies in-duced by mutant strains showed stronger bactericidal activity against Neisseria gonorrhoeae in comparison with those induced by wild strains .Conclusion The recombinant Neisseria gonorrhoeae strain with rmp gene de-letion might eliminate the immunosuppressive effects of Rmp expressed in wild gonococcal strains , which provides a reference for further development of novel live attenuated whole-cell vaccines of Neisseria gonor-rhoeae.
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Objective To investigate the clinical features of the patients with dermatomyositis (DM)complicated with interstitial lung disease(ILD).Methods The clinical manifestations and the laboratory data of the 20 patients with DM complicated with ILD were retrospectively analyzed.Results Among 169 DM patients,20(11.8％)were founded with ILD and 4 had no complaint of respiratory system.The ratio of male to female was 1∶2.33.The level of serum creatine kinase(CK)was elevated in 11 cases.Anti-Jo-1 antibody was positive in 4 cases.Bilateral infiltrates including ground-glass attenuation,interlobular septal thickening and reticular opacities were found by chest high resolution computed tomography.The impairment of lung function was manifested as the decreased diffusion capacity for carbon monoxide of the lung(DLCO)and restricted ventilatory function abnormalities.Fifteen cases showed hypoxemia or respiratory failure by arterial blood gas analysis.All patients were treated with glucocorticoid and/or immunosuppressive agents.Totally,14 patients had improved,while 2 patients with no improvement and 4 patients died with a mortality of 20％.Conclusions DM complicated with ILD which is easily missed has a high morbidity and mortality.The understanding of DM complicated with ILD should be enhanced,thus early diagnosis and intervention could be performed for better prognosis.
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Objective To develop fast detection techniques for the diagnosis of gonococcal infections.Methods Prokaryotic expression vector for Neisserial surface protein A (NspA) was constructed using the NspA gene cloned by PCR.Mice were immunized with the renatured recombinant NspA (rrNspA)to prepare antibodies against NspA.Western blot and ELISA was used to analyze the binding of NspA antibodies to lysate of gonococcal cells or to intact gonococci.Results NspA antibodies that were prepared by the rrNspA expressed in E.coli could bind to rrNspA,the natural NspA existing in gonococcal cells,or intact gonococci.Conclusion RrNspA and its antibodies have potential value in developing fast diagnostic kits for gonococcal diseases.
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ObjectiveTo develop a transgenic mouse model for N.gonorrhoeae researches.Methods Human carcinoembryonic antigen-related cellular adhesion molecules 1 (hCEACAM1) eukaryotic expression vector,pCDPGICAM1,was used to generate transgenic mice by microinjection.The funder mice were screened by PCR,sequence analysis,Western blot and fluorescence-activated cell sorting analysis,respectively.The transgenic mice expressing hCEACAM1 were inoculated with N.gonorrhoeae intravaginally.Adhesion and infection of gonococci to mice were analyzed by bacteria culture and microscopy.Results Four (lines 50,53,54,and 59) of the 22 F0 generation transgenic mice were found to carry the transgene.The hCEACAM1 protein was expressed on the cell membrane of various tissues in the line 53 transgenic mouse.Compared with normal mice,N.gonorrhoeae can successfully infect and cause inflammation in the transgenic mice.Conclusion The hCEACAM1 transgenic mouse can be used as an animal model for gonococcal infections.
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Objective To study the role of human carcinoembryonic antigen-related cellular adhesion molecule 1 (hCEACAM1)in mediating the specific adhesion of N. gonorrhoeae to its human host cells.Methods A recombinant eukaryotic expression vector pCDPGICEA1 was constructed by putting hCEACAM1 cDNA behind both hCD46 promoter and rabbit β-globulin intron 2,and with which,the COS-1 cells were transfected. Following G418 selection, the COS-1 cells expressing hCEACAM1 were sorted out with flow cytometry. The adhesion of N. gonorrhoeae to the gene transfected COS-1 cells was analyzed with bacterial binding assay. Results hCEACAM1 cDNA could be expressed effectively under the direction of hCD46 promoter and rabbit β-globulin intron 2,and N. gonorrhoeae could adhere to COS-1 cells expressing hCEACAM1. Conclusion hCEACAM1 can mediate the adhesion of N. gonorrhoeae to animal originated COS-1 cells. thus its transgenic mice may be used as a novel animal model for studying N. gonorrhoeae infection.
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0.20), but decreased the number of nNOS positive cells in central canal (79% of H saline, P
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Objective To assess the effects of tegaserod on rat with visceral hypersensitivity. Methods Neonatal SD rats were randomized to receive colonic acetic acid irritation between postnatal days 8 and 21 as visceral hypersensitive model (Group H) or by saline intrarectally as control group (Group C). While rats were grown-up, rectal distention (RD) was performed by a balloon rapidly inflated with increasing volumes of saline (0.4, 0.8 and 1.2 ml) for 20 seconds at five-minute intervals. The 5 subgroups of Group H were injected randomly with saline, vehicle (1-methyl-2-thpyrrolidone) or tegaserod at doses of 0.1, 0.3 and 1 mg/kg i.p., respectively. The 2 subgroups of Group C were injected with saline or tegaserod at dose of 1 mg/kg i.p.. RD was performed 10 min after injection and abdominal withdrawal reflex (AWR) was recorded, and then c-Fos expression in spinal cord (L6-S1) was analyzed quantitatively by immunohistochemistry. Results 1) Compared to saline, vehicle did not affect AWR and c-Fos expression. 2) Compared to saline, tegaserod significantly (P