Résumé
Objective:To investigate the efficacy of CT virtual colonoscopy with carbon dioxide (CO 2) versus room air and the effects of bowel cleanliness on polyp detection rate. Methods:A total of 186 patients who underwent CT virtual colonoscopy in the Affiliated Hospital of Hangzhou Normal University (Hangzhou Second People's Hospital), China between October 2015 and November 2020 were included in this study. They were randomly divided into CO 2 and control groups ( n = 93/group). In the CO 2 and control groups, CO 2 and room air were respectively injected through the anus to fill the intestinal cavity. The Boston Bowel Preparation Scale (BBPS) score, abdominal distension score, Visual Analogue Scale (VAS) score, Bruggrmann comfort scale (BCS) score and polyp detection rate were compared between the two groups. Results:According to BBPS score, there were 62 and 60 patients with good bowel cleanliness (BBPS score ≥ 7 points), and 31 and 33 patients with poor bowel cleanliness (BBPS score < 7 points) in the CO 2 and control groups, respectively. There were no significant differences in abdominal distension score, VAS score and BCS score measured during the examination between the two groups (all P > 0.05). At 30 minutes after examination, abdominal distension score and VAS score in the CO 2 group were (2.21 ± 0.40) points and (1.43 ± 0.34) points, respectively, which were significantly lower than those in the control group [(3.50 ± 0.49) points, (3.03 ± 0.55) points, t = 2.59, 2.38, both P < 0.05)]. At 60 minutes after examination, abdominal distension score, VAS score and BCS score in the CO 2 group were (1.15 ± 0.39) points, (1.22 ± 0.28) points, (1.27 ± 0.35) points, which were significantly lower than those in the control group [(2.16 ± 0.43) points, (1.91 ± 0.32) points, (1.85 ± 0.37) points, t = 2.45, 2.27, 2.40, all P < 0.05). The detection rate of small (< 6 mm) - and large (≥ 6 mm) -sized polyps in the CO 2 group was 32.7% (34/104) and 88.1% (37/42), respectively and they were 29.0% (29/100) and 85.1% (40/47) respectively in the control group. There were no significant differences in the detection rate of small- and large-sized polyps between CO 2 and control groups (both P > 0.05). The detection rate of large-sized polyps in patients with good bowel cleanliness in the CO 2 group was 92.3% (24/26) and 89.7% (26/29), respectively, which were significantly higher than those in patients with poor bowel cleanliness in the control group [81.3% (13/16), 77.8% (14/18), χ2 = 6.03, 6.44, both P < 0.05]. The detection rate of small-sized polyps in patients with poor bowel cleanliness in the CO 2 group was 41.9% (26/62) and 42.9% (21/49), respectively, which were significantly higher than those in patients with poor bowel cleanliness in the control group [19.0% (8/42), 15.7% (8/51), χ2 = 15.32, 13.78, both P < 0.01]. Conclusion:CT virtual colonoscopy with CO 2 injection is less uncomfortable than CT virtual colonoscopy with room air and it does not affect polyp detection rate. Bowel cleanliness has a remarkable effect on polyp detection rate in virtual colonoscopy.
Résumé
OBJECTIVE: To investigate the separation and purification technology of total saponins from the root of Thladiantha dubia (TSTR). METHODS: The content of TSTR was determined by UV-visible spectrophotometry. By comparing static adsorption and desorption properties of different types (AB-8, D101, DM130, HPD100, HPD300, HPD450, HPD600, HPD826, NKA-9) of macroporous adsorption resin, the type of macroporous adsorption resin was screened. With the content of TSTR as the index, influential factors of macroporous adsorption resin for adsorbing (ratio of height to diameter of resin, mass concentration of medicine liquid, adsorption volume flow, saturated extent of adsorption) and desorbing (desorption solvent volume fraction, desorption solvent volume flow, volume of desorbed solvent) TSTR were investigated. The optimal technology was screened. The technology validation, purification and preparation were conducted. RESULTS: HPD100 type macroporous adsorption resin had good adsorption and desorption properties for TSTR. The optimal adsorption technology was that the ratio of the height to diameter of the resin column was 1:5; mass concentration of medicine liquid was 1 g/mL; adsorption volume flow rate was 1 BV/h; saturated adsorption capacity was 1. 25 g per 1 g HPD100 resin; the optimal desorption technology was that the volume fraction of desorption solvent ethanol was 75％; volume flow rate of desorption was 3 BV/h; the volume of desorption solvent was 5 BV. The average desorption retention rate of TSTR was 77. 96％ in technology validation (RSD=0. 46％, n=3) and the purity of prepared TSTR in TSTR dry cream was 52. 47％ (RSD =1. 53％, n=3). CONCLUSIONS: The optimal purification technology is stable, feasible and suitable for the separation and purification of TSTR.