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From January 2016 to December 2020, 6 cases of polyps in the appendix cavity with a diameter of 0.3-1.3 cm were treated by endoscopy in the Department of Gastroenterology of Beijing Friendship Hospital, Capital Medical University. All 6 cases underwent endoscopic treatment successfully, including 3 cases of en bloc endoscopic mucosal resection (EMR), 1 case of piecemeal EMR, 1 case of endoscopic submucosal dissection (ESD), and 1 case of removed by cold forceps. No complications such as bleeding, perforation, infection or acute appendicitis occurred.The wound healed well with no recurrence after re-examination in 3 cases, and 3 others were not re-examined by colonoscopy yet. The results preliminarily confirmed that endoscopic treatment of intraluminal polyps in the appendix cavity is safe and effective.
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Objective:To evaluate the effects of single spay of L-menthol (NPO-11) on suppressing gastric peristalsis during upper gastrointestinal endoscopy and the influencing factor.Methods:This study was a multicenter, randomized, double-blind, placebo-parallel controlled study. The eligible patients were randomly divided into two groups by randomized blocks. Patients received local spray of either NPO-11 (160 mg L-menthol) or placebo 20 mL during upper gastrointestinal endoscopy. The gastric peristalsis was recorded and evaluated before, 2 minutes after and at the end of endoscopy. The complexity of the procedure was evaluated by the researchers. The influencing factors for antiperistaltic effect of NPO-11 were analyzed.Results:A total of 220 patients were enrolled from five research centers. There were 109 cases in the NPO-11 group and 111 cases in the placebo group. The baseline data of the two groups were similar and comparable. The proportion of patients with grade 1 peristalsis at 2 minutes after the treatment and at the end of endoscopy was significantly higher in the NPO-11 group than that in the placebo group [40.37% (44/109) VS 16.22% (18/111), χ2=15.93, P<0.001]. Compared with the placebo group, the proportions of weak peristalsis (grade 1 and 2) were higher in the NPO-11 group at 2 minutes after the treatment [67.89% (74/109) VS 46.85% (52/111)] and at the end of endoscopy [79.82% (87/109) VS 48.65% (54/111)]. Subgroup analysis showed that the inhibitory effect of NPO-11 on gastric peristalsis was more significant in Helicobacter pylori antibody positive group. Conclusion:Local spray of NPO-11 can effectively inhibit gastric peristalsis during upper gastrointestinal endoscopy, and its effect is more significant in Helicobacter pylori antibody positive group. It could be recommended for no obvious adverse reactions , its safety, and the convenient procedure.
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Objective:To compare the efficacy of oral sulfate solution (OSS) and polyethylene glycol (PEG) electrolyte powder for colonoscopy bowel preparation.Methods:A total of 283 randomized patients from 9 centers in China taking OSS ( n=143) or PEG ( n=140) using two-day split bowel preparation regimen received colonoscopy and assessment. The primary index was the bowel preparation success rate [global Boston bowel preparation scale (BBPS)≥ 6 by independent assessment center]. Secondary indices included BBPS global and segmental scores, investigator satisfaction (5-point Likert scale) with the quality of bowel preparation, patient satisfaction assessed by questionnaires, and patient tolerance assessed by Sharma scale. Compliance and safety were compared between the two groups. Results:The bowel preparation success rates were 100.0% for OSS and 99.3% for PEG [adjusted difference 0.7% (95% CI: -5.3% - 6.7%), P<0.001 for non-inferiority]. The BBPS global score in OSS group was significantly higher than that in PEG group (8.1 VS 7.7, P<0.001). The segment BBPS scores were also higher in OSS group than those in PEG group for all 3 segments (right colon: 2.4 VS 2.3, P=0.002; transverse colon: 2.8 VS 2.7, P=0.018; left colon: 2.8 VS 2.7, P=0.007). Investigator Likert score in the OSS group was significantly higher than that in the PEG group (2.6 VS 2.3, P<0.001). There was no significant difference in compliance between OSS and PEG, except for the second dose (90.9% VS 82.6%, P=0.039). There was no significant difference in patient satisfaction, Sharma score or proportion of patients with tolerance-related symptoms between the two groups. Safety was comparable between the two groups, and all adverse events were mild to moderate. Conclusion:OSS has comparable efficacy with PEG, with higher BBPS scores in all segments, better investigator satisfaction, better compliance in split dose, and comparable patient tolerance and safety.
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It is important to find the patients with malnutrition or at risk of malnutrition,so that the appropriate nutrition support would be given in time.The nutritional status of inpatients isexamined by various nutrition assessment methods and laboratory indexes.If necessary,when the patient sare discharged the home enteral nutrition therapy should be given under the supervision of community doctors and nurses following the established nutrition support program.With this program the nutritional status can be further improved,the disease recovery and quality of life can be promoted,as well as the economical burden of patients can be reduced.
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Objective To investigate the application value of mini-nutritional assessment short-form(MNA-SF) in screening and evaluating nutritional status in elderly hospitalized patients with malignant tumor.Methods 1472 elderly hospitalized patients(≥65 years old)with malignant tumor were enrolled and prospectively studied for evaluating the nutritional status by nutritional risk screening 2002 (NRS 2002)assessment.Indicators of clinical outcomes were summarized.The consistencies of MNA-SF with body mass index(BMI),grip and results of NRS 2002 assessment,and the relationship between the different nutritional status and clinical outcomes were analyzed.Results The patients meeting the inclusion/exclusion criteria were aged(72.1±5.9)years,with BMI of(22.3 ±3.7)kg/m2 and grip of(21.7± 19.0)kg.Among 16.7％ of the malnourished patients with malignant tumors,pancreatic cancer (30.9 ％),bile duct cancer (24.1％) and esophageal cancer (21.2 ％) occupied the top three incidence of malnutrition,with the lowest (5.4％)incidence in breast cancer.Among 59.2％ of patients being malnourished (16.7％)or at risk(42.5％)of malnutrition,the highest incidence was in bile duct cancer(82.8％),and lowest one was in breast cancer(28.6 ％).MNA-SF-discriminated malnutrition(0～ 7 points)showed a great agreement with malnutrition evaluation by BMI(＜18.5),but had a poor agreement with grip in screening malnutrition.MNA-SF-discriminated nutrition problem(malnourishment plus at risk of malnutrition)showed a great agreement with NRS 2002-discovered nutrition problem (score≥3).Under-nourished patients had a higher infection complication(9.29％ vs.5.14％,P =0.006)and longer hospital stays(15.4 d vs.12.8 d,P＜0.01)as compared with patients with normal nutrition status.Conclusions The prevalence and risk factors for malnutrition are higher in elderly patients with malignant tumor.Poor nutritional status is correlated with poor clinical outcomes.MNA-SF can be used as a tool for evaluating the nutritional status of elderly patients with malignant tumor.
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Objective To investigate the changes of nutritional status of chronic cardiovascular patients during hospitalization by using nutritional risk screening 2002 (NRS 2002) and subjective global assessment (SGA).Methods A prospective,parallel multicenter study was can-ied out in 3 tertiary A hospitals in Beijing from June 2014 to September 2014.Subjects in the study had been hospitalized for 7-30 days for various types of chronic cardiovascular diseases.Physical indexes and laboratory examination results were recorded within 24 hours after admission and 24 hours before discharge.The nutritional status was evaluated using NRS 2002 and SGA.Results 454 inpatients were enrolled in this study.Prevalence of undernutrition,defined as body mass index＜ 18.5 kg/m2 with poor general condition,was 7.0％ on admission.Prevalence of nutritional risk (NRS 2002 score≥3) was 27.9％.Patients with heart valve disease (34.6％) and arrhythmia (47.5％) had higher prevalence of nutritional risk,which decreased on discharge.At admission,the prevalence of SGA-based moderate and severe undernutrition (grade B+C) was 16.7％.In particular,this prevalence was higher in patients with heart valve disease (30.7％) and arrhythmia (22.5％).At discharge,the proportion of patients (except patients with coronary heart disease) with moderate and severe dystrophy,especially severe dystrophy,decreased significantly.Conclusions Patients with chronic cardiovascular disease were likely to have comorbid nutritional risk at the time of admission,including undernutrition,as defined by body mass index＜ 18.5 kg/m2 plus poor general condition,and SGA-based moderate or severe malnutrition,which was partially improved on discharge.Attention should be paid to nutritional status screening and evaluation on admission.Reasonable nutrition intervention should be done to correct malnutrition and improve clinical outcomes.
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Objective To investigate the prevalence of nutritional risk,undernutrition and nutritional support among elderly inpatients with coronary heart disease in 11 tertiary A hospitals in China.Methods Records of elderly patients under the age of 90 with coronary heart disease were collected between March 2012 and May 2012 from 11 tertiary A hospitals in China following the direction of diagnosis related group of Beijing government.Results A total of 1 279 consecutive cases were recruited with the average age 74 years old (65-89).The total nutritional risk prevalence was 28.14％ (360/1 279).The prevalence of nutritional risk and nutritional risk score ≥ 5 increased with age.The prevalence of nutritional risk (12.88％ vs.30.08％ vs.42.28％) and nutritional risk scored ≥5 (10.86％ vs.18.61％ vs.27.78％)increased with age.Judging from BMI,most patients were overweight or obese (BMI ≥ 24 kg/m2),accounting for 53.0％ of the total,and prevalence of nutritional risk in this subgroup was 15.12％ (96/635).The prevalence of nutritional risk in patients with normal BMI was 34.24％.The prevalence of undernutrition defined as BMI＜ 18.5 kg/m2 was 4.25％ (51/1 279),among which patients with score ≥ 5 account for 64.7％ (33/51).The prevalence of undernutrition defined as nutritional impairment score =3 was 7.58％ (97/1 279).In patients with nutritional risk,57 were administrated nutrition support (16.6％);in patients without nutritional risk,21 received nutrition support,mostly parenteral nutrition (16 cases,76.2％).In patients with nutritional risk [(79.46± 7.19) years vs.(76.40± 6.16) years],there were statistically significant difference between those who received nutrition support and those who did not in terms of age and the ratio of patients with nutritional risk scored≥5 (35.1％ vs.17.1％) (P =0.001,P=0.002).Conclusions The prevalence of nutritional risk in patients with coronary heart disease was high.The prevalence of undernutrition was low.Prevalence of overweight and obese was high,but there was still nutritional risk in this group of patients.The patients who received nutrition support were older and had high nutritional impairment score,but the indication is not rationale.
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Objective To evaluate the clinical and esophageal dynamics characteristics, and initial treatment effect of patients with untreated achalasia using high resolution manometry. Methods From January 2012 to June 2016, patients newly diagnosed with achalasia were retrospectively recruited. Clinical information, endoscopy and X-ray findings, manometric variables and treatment outcomes were collected and compared among manometric subtypes. Results Among 133 patients with achalasia, 32 ( 24. 0%) were classified as type Ⅰ, 84 ( 63. 2%) as typeⅡ and 17 ( 12. 8%) as typeⅢ. Compared with the typeⅢ, the symptom of regurgitation was more common in the types I and typeⅡachalasia patients ( P=0. 020) . While compared with the type Ⅰ, the score of chest pain was higher in the patients with type Ⅱ and type Ⅲ ( P=0. 006) , as well as the basal lower esophageal sphincter pressure ( P=0. 015, P=0. 023 for type Ⅱ and type Ⅲ, respectively) . Integrated relaxation pressure was similar among the 3 subtypes ( P=0. 158) . Forty-five and 47 patients received pneumatic dilation ( PD ) and peroral endoscopic myotomy ( POEM ) respectively, and all of the patients were followed-up for at least 6 months. The success rate was higher in the POEM group than that of the PD group in all the 3 manometric subtypes, but only the difference between POEM and PD in the type Ⅲ was statistically significant ( 90. 0% VS 40. 0%, P = 0. 041 ) . Conclusion The clinical characteristics and treatment response are different among the 3 achalasia subtypes. Patients with type Ⅲ achalasia are probably the best candidates for POEM.
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Objective To evaluate the clinical and esophageal dynamics characteristics, and initial treatment effect of patients with untreated achalasia using high resolution manometry. Methods From January 2012 to June 2016, patients newly diagnosed with achalasia were retrospectively recruited. Clinical information, endoscopy and X-ray findings, manometric variables and treatment outcomes were collected and compared among manometric subtypes. Results Among 133 patients with achalasia, 32 ( 24. 0%) were classified as type Ⅰ, 84 ( 63. 2%) as typeⅡ and 17 ( 12. 8%) as typeⅢ. Compared with the typeⅢ, the symptom of regurgitation was more common in the types I and typeⅡachalasia patients ( P=0. 020) . While compared with the type Ⅰ, the score of chest pain was higher in the patients with type Ⅱ and type Ⅲ ( P=0. 006) , as well as the basal lower esophageal sphincter pressure ( P=0. 015, P=0. 023 for type Ⅱ and type Ⅲ, respectively) . Integrated relaxation pressure was similar among the 3 subtypes ( P=0. 158) . Forty-five and 47 patients received pneumatic dilation ( PD ) and peroral endoscopic myotomy ( POEM ) respectively, and all of the patients were followed-up for at least 6 months. The success rate was higher in the POEM group than that of the PD group in all the 3 manometric subtypes, but only the difference between POEM and PD in the type Ⅲ was statistically significant ( 90. 0% VS 40. 0%, P = 0. 041 ) . Conclusion The clinical characteristics and treatment response are different among the 3 achalasia subtypes. Patients with type Ⅲ achalasia are probably the best candidates for POEM.
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Objective To investigate laparoscopic management in patients of posttraumatic acute acaleulous cholecystitis (AAC).Methods In this study,laparoscopic exploration was performed in 14 AAC cases during the past 5 years.Results Nine patients were treated with laparoscopic cholecystectomy,three by laparoscopic subtotal cholecystectomy,two were converted to open surgery.All patients were cured without major complications.Conclusions Laparoscopic cholecystectomy in the treatment of AAC is safe,less traumatic and quickly recovery in carefully selected AAC patients.
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Objective:To me affiliated hospitals are currently using Shimadzu CL8000 Hitachi 7180 automatic biochemical analyzer comparison study on Shimadzu CL8000 Hitachi 7180 automatic biochemical analyzer cleaning effect for clinical obtain accurate test results provide a reliable basis. Methods:Patients with the same blood samples TG, TBA testing, using different instruments, different sequence of tests in order to determine Hitachi 7180 automatic biochemical analyzer and Shimadzu CL8000 automatic biochemical analyzer test results whether they carry the previous reagents, according to the detection results to determine two kinds of automatic biochemical analyzer after cleaning effect. Results:A group of TBA measurements were significantly higher than in group B, C group, D group(x2=4.091, P<0.05), comparing the results with statistical significance;B group, C group, D group compared TBA measurements no significant difference, the difference was not statistically significant. Conclusion:Shimadzu CL8000 automatic biochemical analyzer cleaning better than Hitachi 7180 automatic biochemical analyzer, its stable performance, excellent cleaning effect, clinicians can provide accurate diagnosis and treatment basis, improve patient outcomes, quality of life and protect their life safety, may be of clinical use.
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Objective: To evaluate CR (Computer X-ray imaging system) and DR (digital X-ray imaging system) imaging performance, features, advantages and disadvantages, and for application-level comparative analysis instrumentation for clinical application of scientific and rational resource reference. Methods:In the city diethyl hospital radiology shot 852 CR and DR tablets were retrospectively analyzed, focusing on the performance evaluation of two components as affecting the quality characteristics and radiography, focusing compare their clinical applications. Results:CR imaging quality was 89.9%, DR was 94.8%, DR radiography quality is higher than the CR, the difference was statistically significant(x2=7.864, P0.05). Conclusion: CR and DR mutual advantages and disadvantages, CR flexible, and lower cost, but the DR over CR has a higher spatial resolution, wider dynamic range and lower X-ray radiation, and a low rate of waste film radiography speed, high work efficiency. Suggest playing two advantages for clinical applications to provide more choices.
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BacKground:AchaIasia of cardia is categorized into 3 subtypes by Chicago cIassification criteria defined by high-resoIution manometry( HRM). These different subtypes present different cIinicaI and esophageaI dynamic characteristics. Aims:To study the cIinicaI and esophageaI dynamic characteristics of patients with achaIasia of cardia categorized by Chicago cIassification criteria. Methods:Twenty-five untreated achaIasia of cardia patients from January 2012 to ApriI 2014 at Beijing Friendship HospitaI,CapitaI MedicaI University were enroIIed. CIinicaI data incIuding cIinicaI symptoms, manifestations of endoscopy and barium meaI radiography and data of HRM were anaIyzed retrospectiveIy. Results:Of the 25 patients,5 patients(20. 0%)were cIassified as type Ⅰ,15(60. 0%)as type Ⅱ and 5(20. 0%)as type Ⅲ. AII patients compIained as having dysphagia,and 26. 7%( 4/15 ) of type Ⅱ patients had chest pain. Incidences of regurgitation in typeⅠ,ⅡandⅢwere 60. 0%(3/5),53. 3%(8/15)and 20. 0%(1/5),respectiveIy,no significant difference was found among the three types(P>0. 05). Incidences of diIatation of esophagus in type Ⅰ,ⅡandⅢwere 60. 0%(3/5),73. 3%(11/15)and 20. 0%(1/5),respectiveIy,no significant difference was found among the three types (P=0. 11). No differences in Iength of Iower esophageaI sphincter(LES),abdominaI LES Iength,LES resting pressure, upper esophageaI sphincter( UES)resting pressure and integrated reIaxation pressure( IRP)among the three types were found(P>0. 05). Incidences of muItipIe swaIIowing and spontaneous UES reIaxation were 32. 0%(8/25)and 24. 0%(6/25),respectiveIy,no significant difference was found among the three types(P>0. 05). Conclusions:Of the patients with achaIasia of cardia ,typeⅡis more common. Large-sampIe muIticenter studies are needed for further research.
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ObjectiveTo evaluate magnesium sulfate and compound polyethylene glycol electrolyte in bowel preparation before capsule endoscopy.MethodsA total of 81 patients were randomly divided into two groups.Group A (n =41 ) received compound polyethylene glycol electrolyte,and group B (n =40) received magnesium sulfate combined with compound polyethylene glycol electrolyte. Positive detection rate,intestinal preparation score,the incidence of capsule retention and solution quality,liver and kidney function were compared between those two groups.ResultsThe positive detection rates of capsule endoscopy were 65.9％ (27/41) in group A and 62.5％ (25/40) in group B,which were nonsignificantly different (x2 =0.099,P ＞ 0.05).The intestinal preparation scores of 19 patients in group A were ≤4 and those of 22 patients were ≥6,while those of 28 patients in group B were ≤4 and of 12 patients were ≥6,which were significantly different (x2 =4.653,P ＜ 0.05). The rates of capsule retention of group A and B were 2.4％( 1/41 ) and 5.0％ (2/40) respectively,which were not significantly different (x2 =0.372,P ＞ 0.05 ).Obvious abdominal pain,nausea or vomitting occurred in no patients of the two groups.There was no difference in electrolyte level or liver and kidney function between those two groups (P ＞ 0.05 ).ConclusionMagnesium sulfate combined with compound polyethylene glycol electrolyte is applicable for the bowel preparation before capsule endoscopy.
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Objective To assess and compare the efficacy and safety of ecabet sodium-based quadruple therapy versus bismuth-based quadruple therapy for Helicobacter pylori (Hp) eradication.Methods A multicenter,randomized,positive controlled clinical trial was carried out.The object of the study were chronic gastritis patients at 8 hospitals in Xi'an,Beijing,Shanghai and Guangzhou from June 2009 to June 2011.All patients were divided into treatment group and control group.In treatment group,patients received ecabet sodium-based quadruple therapy (two times per day,omeprazole magnesium 20 mg,amoxicillin 1000 mg,clarithromycin 500 mg and ecabet sodium 1.0 g each time for 10 days.In control group,patients were assigned to receive bismuth-based quadruple therapy (two times per day; omeprazole magnesium 20 mg,amoxicillin 1000 mg,clarithromycin 500 mg and bismuth potassium citrate 220 mg each time) for 10 days.The Hp eradication was determined by 13C or 14C urea breath test at the 38th day after the treatment and the eradication rate was calculated.Side effects were recorded and analyzed.The data were analyzed by chi square test and Fisher's exact test.Results A total of 311 patients were recruited,and 155 patients were allatted in treatment group and 156 in control group.The per-protocol (PP) analysis indicated that the eradication rates of treatment group arid control group were 75.71％(106/140) and 77.37％(106/137) respectively,and there was no significant difference x2 =0.106,P=0.745).The intention-to-treat (ITT) analysis indicated that the eradication rates of treatment group and control group were 68.39％ (106/155) and 67.95％ (106/156) respectively,and there was no significant difference x2 =0.007,P=0.934).The side effects rates of treatment group and control group were 20.00％ (31/155) and 25.64％(40/156) respectively,and the difference was not statistically significant (Fisher's exact test,P=0.280).No serious side effect was observed in two groups.Conclusion The efficacy and safety of ecabet sodium-based quadruple therapy for Hp eradication in chronic gastritis patients may be the same as bismuth-based quadruple therapy.
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to be resistant to antibiotics.
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Objective To determine the function and clinical significance of OMOM capsule endos-copy. Methods To review the history and outcomes of 65 patients underwent capsule endoscopy from Oct. to Dec. 2004. Results OMOM capsule endoscopy failed to pass the pylorus within the effective working time in one case. The significant pathological findings were revealed in 47 patients among 64 patients (73. 4% ). Inflammatory small bowel diseases in 21 patients including Crohn's disease in 3 patients, small intestinal pol-yps in 8 patients including one Peutz-Jeghers syndrome, angiodysplasia in 9, diverticula in 3, hookworm in 3, submucosal tumor in 3 including one myosarcoma finally diagnosed by operation. OMOM capsule endosco-pies have working time 473 min (360-630) averagely. The duration from oral to anus was 1723 min (690-2370 min) averagely. Conclusion The capsule endoscopy is a highly useful technique in detecting small in-testinal diseases. It can be recommended as part of the routine work-up in patients with obscure bleeding.