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Objective The invasive colonoscopy is an important method for evaluating the severity of intestine and the muco-sal healing in ulcerative colitis(UC)patients. The aim of this study was to investigate the advantage of fecal calprotectin(FC)in diagnosing UC endoscopic activity and severity and analyze the FC correlation with endoscopic scores. Methods A total of 70 UC in-patients in our hospital from January 2016 to September 2017 were retrospectively analyzed and categorized into endoscopic remission UC [mucosal healing(n=12),mucosal lesion(n=10)]and endoscopic active UC[mild-moderate(n=30)and severe(n=18)]according to UC Endoscopic Index of Severity(UCEIS).The ROC curve was used to analyze the predictive efficacy of each laboratory indicator to identify endoscopically active UC and severe UC and evaluate the correlation of UCEIS with all these indicators. Results In UC pa-tients,the levels of FC[828.5(416.6,1079.7)μg/g],PCT[0.03(0.02,0.06)μg/L]and IL-6[13.4(7.32,21.45)ng/L]were sig-nificantly higher in endoscopically active UC than those[43.4(9.4,91.4)μg/g、0.02(0.02,0.03)μg/L、5.82(5.14,6.73)ng/L]in remission and the levels of CRP,ESR,WBC count and PLT count also increased significantly,while HB and ALB levels were signifi-cantly lower than those in remission(all P value<0.001).In endoscopically active UC patients,the levels of FC[1117.1(916.5,1492. 4)μg/g]and IL-6[18.18(12.72,33.25)ng/L]were significantly higher than those of mild-moderate UC[622.4(218.7,924.2)μg/g,8.27(7.08,16.60)ng/L](P<0.05)and the levels of CRP,ESR and WBC also increased significantly(P<0.05),while the ALB showed a significant lower level(P=0.002). When FC>175.6 μg/g,it was of higher accuracy in diagnosing UC endoscopic activity and the sensitivity,specificity,positive predictive value and negative predictive value were respectively 87.50%,90.91%,95.45%and 76.92%;When FC>781.1 μg/g,it was of higher accuracy in diagnosing severe UC and the sensitivity,specificity,positive predic-tive value and negative predictive value were respectively 88.89%,73.33%,66.66% and 91.66%. The levels of FC,PCT,IL-6, CRP,ESR,WBC and PLT all presented positive correlation with UCEIS(P<0.001),while the HB and ALB levels showed a negative correlation with UCEIS(P<0.001). Conclusion FC is a good indicator to judge UC endoscopic activity and severe UC. FC can be used as a non-invasive and surrogate marker for endoscopy to monitor UC disease activity in clinical practice.
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Objective:To observe ulcer characteristics of Crohn's disease under double balloon enteroscopy,and to evaluate the correlation between endoscopic severity and clinical manifestations.Methods:A prospective,observational study from July 2015 to December 2016 in the Third Xiangya Hospital,Central South University,we selected 45 patients with positive double-balloon enteroscopy (DBE) and confirmed Crohn's disease.Two digestive internal physician observed the ulcer characteristics of Crohn's disease under double balloon enteroscopy,and gave a simple endoscopic score for CD (SES-CD).We analyzed the correlation between SES-CD and Crohn's disease activity index (CDAI).Results:DBE indicated 24 patient ulcers (53.33％) locating at the end of the ileum,5 (11.11％)locating at ileocolon,16 (35.56％) locating at upper gatrointestinal tract and they did not affect the end of the ileum.Among them,8 cases (17.78％) affected only jejunum.Thirty-two patients with longitudinal ulcers in Crohn's disease,accounting for 71.11％.There was no correlation between SES-CD score and CDAI score (r=0.237,P=0.136).Conclusion:The ulcerative appearance in Crohn's disease were diverse under double balloon enteroscopy.Crohn's disease could only affect the upper gastrointestinal tract or jejunum.The unwounded ileum and ileocecal valve couldn't be a sign to exclude Crohn's disease.CDAI score couldn't fully assess the prognosis of Crohn's disease.
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Endoscopic activity has been used as an endpoint in treatment of Crohn's disease (CD).Simplified Endoscopic Score for Crohn's Disease (SES-CD) is a simple and easy-to-use endoscopic scoring system for CD, however, studies evaluating the correlation between SES-CD and noninvasive inflammatory markers are scarce.Aims: To investigate the correlation between SES-CD and clinical and laboratory inflammatory markers for identifying a noninvasive surrogate marker for endoscopic activity of CD.Methods: Forty-two patients with CD were enrolled for detecting laboratory inflammatory markers including leukocyte and platelet count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), hemoglobin (Hb), albumin (Alb) and fecal calprotectin (FC);SES-CD and Crohn' disease activity index (CDAI) were assessed.Predictive performance of these markers for endoscopic activity of CD was analyzed by ROC curve, and the correlation of SES-CD with all these markers was evaluated.Results: The platelet count, CRP, ESR, FC and SES-CD were significantly higher in active CD than in inactive CD, while Hb and Alb were significantly lower in active CD (P all <0.05).In all the noninvasive markers, only CDAI and FC had an area under the curve (AUC) greater than 0.9 for predicting CD endoscopic activity.Taken 150 as the cut-off value of CDAI and 50 μg/g (the upper limit of normal, ULN) as the cut-off value of FC, the sensitivity of CDAI and FC were 58.8% and 100%, and the specificity were 100% and 60.0%, respectively.SES-CD had moderate correlation with CDAI, platelet count, CRP, ESR, Alb and FC, respectively (P all <0.05).Conclusions: SES-CD is correlated moderately with the clinical and laboratory inflammatory markers, however, when taken the ULN as cut-off value the conventional inflammatory markers such as CDAI, CRP and ESR are hard to predict sensitively and accurately the endoscopic activity of CD;while FC has fairly high accuracy and sensitivity and can be used as a noninvasive surrogate marker for evaluating endoscopic activity of CD.
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Objective To explore the effect of DIP endoscopic marking scheme in evaluation of patients with chronic sinusitis endoscopic surgery.Methods 96 patients with chronic sinusitis were chosen from July 2013 to September 2014.According to the random nmuber method,the patients were divided into observation group and control group,48 cases in each group.All patients were gvien Messerklinger surgery for chronic sinusitis endoscopic surgery. Preoperation and postoperative 3 months,the lateral nasal videos were recorded,the observation group DIP video was used in patients with endoscopic rating marking scheme,the control group patients were given the Land -Mackay CT rating marking scheme,and analyzed the grading results.At the same time,the treatment for each patient to be efficient and the correlation of two grades were studies.Results Before operation,Land -Mackay CT scoring and DIP endoscopic score showed positive correlation (r =0.937,P <0.05 ).3 months after operation,Land -Mackay CT score and DIP endoscopic score also showed a positive correlation (r =0.546,P <0.05).The grading of the observa-tion group and control group in preoperative surgery showed significantly lower,the difference was statistically signifi-cant (r =0.435,P <0.05).The effective rate of the observation group was 91.67%,which was obviously higher than 72.92% of the control group (χ2 =13.935,P <0.05).Conclusion DIP endoscopic marking scheme in patients with chronic sinusitis endoscopic surgery has a better evaluation result.
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[Abstract ] Objective Pelvic radiation disease(PRD) is multiple injuries in more than one organ resulted by pelvic radio-therapy.Patients have the symptoms of frequent feces and fecal incontinence after the resection of small bowel lesion .Sugeries on PRD patients were mainly distal ileum and ilieocecal valve resections , while the most susceptible part of pelvic radiation injury is rectum . However , little research has been done concerning PRD patients′anorectal functions .This study was mainly to evaluate the anorectal function of cervical cancer patients with PRD in order to provide evidence for the therapy and prognosis of PRD . Methods Cervical cancer patients with PRD in need of small bowel resection who hospitalized in our department from January 2014 to January 2015 were collected as patient group , while people from outpatient physical exam group were selected as control group according to the exclusion criteria of hypertension , diabetes, constipation and unrelaxed pelvic floor syndrome .PDR group and control group were matched according to age.All subjects underwent colonoscopy and anorectal manometry .Rectal radiation injury was estimated on the basis of colonoscopy results.Anorectal manometry results of PRD group and control group were analysised statistically . Results PRD group and control group both included 20 women without stenosis or obstruction in rectum .Significant difference was found between PRD group and con-trol group in anal resting pressure (47.23 ±9.08 mmHg vs 58.25 ±9.24 mmHg, P<0.05), anal maximum squeezing pressure (47.23 ±9.08 mmHg vs 58.25 ±9.24 mmHg, P<0.01), anal distension pressure (23.30 ±12.49 mmHg vs 39.10 ±9.99 mmHg, P<0.01), rectal defecation pressure(22.85 ±16,69 mmHg vs 50.90 ±9.14 mmHg, P<0.01) and maximum tolerated rectal volume (112.85 ±51.34 mL vs 173.50 ±48.15 mL, P<0.01).There was no significant difference between the two groups as to the lenghth of functional sphincters(P=0.313),rectum initial threshold(P=0.416) and rectal defecation threshold(P=0.161). Conclusion Ionization radiation that injures PRD patients′internal anal sphincters and external anal sphincters also reduces maximum tolerated rec -tal volumes preoperatively .It′s necessary to assess the muscles and nerve functions of anorectum before intestinal surgery in order to make a proper operation plan which will improve PRD patients′life quality.
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Objective Study the useful effect of the subjective and objective assessmentscale in fungal‐rhino‐sinusitis (FRS) patients before and after endoscopic sinus surgery ,and thier transition rules .Methods Visual analog scale (VAS) ,sino‐nasal out‐come measures 20 (SNOT‐20) ,Lund‐Mackay CT score and Lund‐Kennedy nasal endoscopy score were used to prospective evaluate 130 cases of FRS patients at the time of before endoscopic sinussurgery ,the 3rd month and the6thmonth after survey ,and correla‐tion analysiswas took between the various scales .Results At the time ofbeforesurgery ,the 3rd month and the 6th month after the endoscopic sinus surgery ,the VAS ,SNOT‐20 ,Lund‐Mackay sinus CT scores and Lund‐Kennedy endoscopic score were significantly correlated (P0 .05) .Except for SNOT‐20 scores at the time of 3rd month had relationship with preoperative scores(P 0 .05) .The difference ofSNOT‐20 ,VAS ,Lund‐Kennedy nasal endoscopy scorewas statistically significant compared to each other at the time of 3rd month and the 6th month after surgery (P<0 .05) .Conclusion Subjective combined with objective scale can be a better response for patients be‐fore surgery ,which may be helpful for the choosing of operation time;combination of postoperative subjective evaluation with objec‐tive evaluation and following‐up ,may be a more effect way for patient to kmow the outcome after surgery .