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Objective:To explore the value of linaclotide combined with compound polyethylene glycol electrolytes powder (PEG) for bowel preparation for colonoscopy.Methods:A randomized and single blind prospective clinical study was conducted in patients who intended to receive colonoscopy at the Department of Gastroenterology in Shenzhen Hospital, Southern Medical University from June 2021 to August 2021. One hundred and fifty-two patients in the experimental group were treated with 580 μg linaclotide + 2 L PEG, and 152 patients in the control group were treated with 3 L PEG. The bowel preparation effects including Boston bowel preparation scale (BBPS) score, bubble score and lesion detection rate, and safety (adverse events) were compared between the two groups.Results:The total BBPS scores were 9 (8, 9) in the experimental group, and 9 (9, 9) in the control group with no significant difference ( Z=0.141, P=0.888). The bubble scores were 1 (1, 2) in the experimental group, and 1 (1, 1) in the control group with no significant difference ( Z=1.788, P=0.074). There was no significant difference in detection rate of lesions between the experimental group and the control group [37.50% (57/152) VS 33.55% (51/152), χ2=0.517, P=0.472]. There was no significant difference in safety including incidence of nausea [7.24% (11/152) VS 13.16% (20/152), χ2=2.910, P=0.088], vomiting [2.63% (4/152) VS 7.24% (11/152), χ2=3.436, P=0.064], abdominal distension [7.89% (12/152) VS 11.84% (18/152), χ2=1.331, P=0.249] and abdominal pain [2.63% (4/152) VS 4.61% (7/152), χ2=0.849, P=0.357] between the experimental group and the control group. Conclusion:Linaclotide combined with PEG for colonoscopic bowel preparation reduces drinking water volume. The cleaning effect and safety are comparable to using 3 L PEG. It can be recommended for bowel preparation for colonoscopy.
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Objective:To explore the association of the impaired cognition and the deposition of β-amyloid (Aβ) in normal cognitive (NC) and mild cognitive impairment (MCI).Methods:From December 2018 to January 2021, 305 subjects (113 males, 192 females; age (64.0±7.7) years) who completed neuropsychological tests and MRI in Shanghai Sixth People′s Hospital, Shanghai Jiao Tong University and 18F-florbetapir (AV45) PET imaging in Huashan Hospital, Fudan University were retrospectively analyzed. The subjects were divided into MCI group and NC group based on neuropsychological tests, and each group was further divided into Aβ-positive and Aβ-negative based on PET imaging results. Independent-sample t test, Mann-Whitney U test and χ2 test were used to analyze the data. Results:There were 118 subjects in MCI group and 187 subjects in NC group. The Aβ-positive rate in MCI group (37.3%, 44/118) was higher than that in NC group (26.2%, 49/187; χ2=4.19, P=0.041). The assessment performances of MCI group in general cognitive function, memory function, language function and executive function were inferior to those of NC group ( t values: from -10.63 to -6.31, z values: from -11.01 to -6.03, all P<0.001). The Auditory Verbal Learning Test-Long Delay Recall (AVLT-LDR) score of Aβ-positive subjects was lower than that of Aβ-negative subjects in MCI group (1.00(0.00, 3.00) and 3.00(1.00, 4.00); z=-2.49, P=0.013). The Montreal Cognitive Assessment Basic (MoCA-B) score of Aβ-positive subjects was lower than that of Aβ-negative subjects in NC group (25.29±2.67 and 26.36±2.42; t=-2.61, P=0.010). Conclusion:Compared to Aβ-negative subjects, MCI patients with Aβ-positive perform worse on memory tests, and NC subjects with Aβ-positive perform worse on general cognitive function.
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Objective:To explore the β-amyloid (Aβ) deposition pattern of subjects with the preclinical Alzheimer′s disease (AD), community-derived amnestic mild cognitive impairment (aMCI) and normal cognition (NC) from communities of Shanghai.Methods:According to the inclusion and exclusion criteria, 273 subjects (104 males, 169 females; age (64.2±7.6) years) were recruited from Shanghai community and memory clinics from December 2018 to July 2020. All subjects underwent MRI, 18F-AV45 PET imaging and neuropsychological scale tests and were grouped into AD, aMCI and NC groups based on clinical diagnosis. Differences in demographic information, the neuropsychological scale tests′ scores and positive rate of Aβ deposition among each group were analyzed by one-way analysis of variance or χ2 test. Aβ deposition patterns of AD and MCI groups were analyzed at voxel level, and the differences of Aβ deposition among different groups were compared. Results:Among 273 patients, the positive rates of Aβ deposition in AD, aMCI and NC groups were 84.4%(38/45), 36.4%(20/55) and 23.1%(40/173), respectively ( χ2=58.37, P<0.001). Among AD, aMCI, NC and NC (Aβ-) groups ( n=132), the education years of AD group was the lowest ((9.7±4.6) years; F=8.86, P<0.001). In addition, there were significant differences in the scores of several neuropsychological scale tests among AD, aMCI, NC groups and NC (Aβ-) group ( F values: 27.68-235.50, all P<0.001). Compared with subjects in NC(Aβ-) group, the Aβ depositions in the aMCI and AD groups were widely distributed in the whole cerebral cortex; and AD group had higher Aβ deposition in bilateral frontal, parietal, temporal, occipital lobe, cingulate gyrus and precuneus than aMCI group. Conclusions:The positive rate of Aβ deposition in the preclinical AD population from the Shanghai community is obtained. There are significant different Aβ deposition patterns in subjects at different stages of AD.
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To explore the effects of simethicone combined with compound polyethylene glycol for bowel cleaning on the detection rate of intestinal polyps. A total of 300 patients undergoing colonoscopy from May to July 2020 were randomly divided into group A and B. Patients in group A only used 2 packets of compound polyethylene glycol electrolyte powder for bowel cleaning. Patients in group B took simethicone combined with compound polyethylene glycol for intestinal cleaning. The time, method and dosage of compound polyethylene glycol were the same as those of group A. Intestinal cleanliness, intestinal defoaming degree, intestinal polyp detection rate and incidence of adverse reactions in group A and B were compared respectively. The scores of intestinal cleaning, the rate of intestinal foam removal and the detection rate of large and small polyps in group B were higher than those in group A. There was no significant difference in the incidence of short-term adverse reactions between the two groups. However, the incidence of postoperative abdominal distension in group B was significantly reduced. Simethicone combined with compound polyethylene glycol for bowel cleaning can significantly improve the degree of intestinal cleaning and improve postoperative abdominal distension. It has obvious effects on improving the detection date of intestinal polyps and preventing the occurrence of certain intestinal tumors. The method is simple, feasible and economical, which is worth promoting.
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Objective To evaluate effects of different admission time of polyethylene glycol-electrolyte lavage solution ( PEG-ELS) regimens on bowel preparation before colonoscopy in children and to seek better regimens. Methods Children ( 3-18 years old ) receiving colonoscopy under sedation in Shanghai Children's Medical Center from July 2016 to July 2017 were prospectively enrolled in the controlgroup ( n=64) and intervention group ( n=97) , according to convenience sampling. Children in the control group on the two-day regimen took PEG-ELS at 7 pm for 2 consecutive nights before colonoscopy, and those in the intervention group took PEG-ELS at 7 pm the day before colonoscopy and 4:30 am on the day of colonoscopy. All children had the same low-fiber diet for 3 days before colonoscopy. Main outcome measures were intestinal clearance and enema rate. Secondary outcome measures were medication compliance, acceptance and tolerance. The Chi-square test was used to analyze the relevant indicators between the two groups. Results There were no significant differences in gender composition, mean age, indication composition and medication adherence between the two groups ( P>0. 05) . The intestinal clearance rate was significantly higher in the intervention group than that in the control group [ 93. 8％ ( 91/97 ) VS 42. 2％(27/64)] with significant difference (χ2=52. 502, P=0. 000). The enema rate was significantly lower in the intervention group[ 17. 5％ ( 17/97) VS 96. 9％ ( 62/64) ] with significant difference (χ2=97. 145, P=0. 000). In terms of medication acceptance, the acceptance rate of the intervention group was higher[51. 5％( 50/97) VS 39. 1％ ( 25/64 ) ] with no significant difference (χ2 = 0. 215, P= 0. 643 ) . In terms of medication tolerance, the asymptomatic rate of the intervention group was higher than that of the control group [ 36. 1％ ( 35/97) VS 14. 1％ ( 9/64) ] , and the difference was statistically significant (χ2=14. 062, P= 0. 007 ) . The incidence of nausea was lower in the intervention group [ 1. 0％ ( 1/97 ) VS 6. 3％(4/64)], with no significant difference (χ2=3. 490, P=0. 082).The incidence of vomiting was higher in the intervention group [29. 9％ (29/97) VS 29. 7％ (19/64)] with no significant difference (χ2=0. 001, P=1. 000).The incidence of abdominal pain was lower in the intervention group [25. 8％ (25/97) VS 43. 8％ (28/64)] with significant difference (χ2=5. 643, P=0. 025).The incidence of anal discomfort was higher in the intervention group [7. 2％ (7/97) VS 6. 3 ％(4/64)], with no significant difference (χ2=0. 057, P=1. 000) . Conclusion The one-day split-dosage PEG-ELS regimen has better efficacy and safety in bowel preparations, and it can effectively reduce the incidence of abdominal pain.