Application of fiber Raman endoscopic probe in the diagnosis of gastric cancer / 南方医科大学学报

OBJECTIVE@#To develop a fiber Raman endoscopic probe that can be integrated in a gastroscope and evaluate its value in the diagnosis of gastric cancer.@*METHODS@#The Raman spectra of gastric cancer tissues and normal tissues were obtained using the fiber Raman endoscopic probe and confocal microRaman spectroscopy. After preprocessing with smoothing, baseline elimination and normalization, the spectroscopic data were analyzed by the principle component analyses combined with stechiometry. Based on the pathological results, the diagnostic accuracy, sensitiveness and specificity of Raman spectroscopy combined with stechiometry were evaluated.@*RESULTS@#The fiber Raman endoscopic probe and microRaman spectroscopy revealed significantly different Raman spectra between gastric cancer tissues and normal tissues. The diagnostic accuracy, sensitiveness and specificity of the fiber Raman endoscopic probe was 80.56%, 88.89%, and 84.72% for gastric cancer, respectively.@*CONCLUSIONS@#The fiber Raman endoscopic probe combined with stechiometry provides an effective modality for the diagnosis of gastric cancer and can well distinguish gastric cancer tissue from normal gastric tissues.

Clinical Study on 2 Kinds of Proton Pump Inhibitors in the Treatment of Coronary Heart Disease / 中国药房

OBJECTIVE:To investigate the effectiveness and safety of 2 kinds of proton pump inhibitors in the treatment of coronary heart disease (CHD).METHODS:In retrospective study,a total of 92 patients with CHD were selected from our hospital during Jun.2015-May 2016,and then divided into rabeprazole group (30 cases),esomeprazole group (32 cases) and control group (30 cases) according to therapy plan.Control group received basic therapy plan.Rabeprazole group and esomeprazole group were additionally given sodium rabeprazole enteric-coated tablets and Esomeprazole magnesium enteric-coated tablets 20 mg,po,bid,on the basis of control group.A treatment course lasted for 30 d,and both medication groups received 2 courses of treatment.Blood uric acid levels,urine pH values,blood ion levels (Na+,K+,Ca2+,Cl-) were detected before and after treatment.The occurrence of cardiovascular adverse events,coronary adverse events and other adverse events were observed in 2 groups during treatment.RESULTS:Before treatment,there was no statistical significance in above indexes among 3 groups (P＞0.05).After treatment,the levels of blood uric acid,K+ (except for control group),Ca2+ and Cl-were decreased significantly,while urine pH values and blood Na+ levels were increased significantly;the levels of blood uric acid and Ca2+ in rabeprazole group and esomeprazole group were significantly lower than control group,while urine pH value and blood Na+ level were significantly higher than control group,with statistical significance (P＜0.05).After treatment,the level of blood uric acid in rabeprazole group was significantly lower than esomeprazole group,with statistical significance (P＜0.05).But there was no statistical significance in urine pH values or ion levels between 2 groups (P＞0.05).Compared with control group,the incidence of acute thrombosis in rabeprazole group and esomeprazole group were decreased significantly,and the incidence of joint swelling and pain were increased significantly,with statistical significance (P＜0.05).There was no statistical significance in the incidence of coronary adverse events among 3 groups (P＞0.05).CONCLUSIONS:Rabeprazole and esomeprazole can significantly reduce the level of blood uric acid and the incidence of acute thrombosis,increase urine pH value and blood Na+ levels,decrease blood Ca2+ level and increase the risk of fracture or hypocalcemia in patients with CHD.Therefore,the dosage regimen should be adjusted according to the specific situation of patients in clinical practice

Mucosal healing quality of hydrotalcite combined with esomeprazole in gastric ulcer / 中华消化杂志

Objective To explore the mucosal healing quality of hydrotalcite combined with esomeprazole in gastric ulcer.Methods Forty-two patients visiting from June 2014 to December 2015 and diagnosed with gastric ulcer were selected and divided into combination therapy group and single therapy group with 21 patients in each group.The patients of combination therapy group received esomeprazole combined with hydrotalcite,and the patients of single therapy group received esomeprazole alone.The total therapeutic course was eight weeks.At the same period,21 health check-up participants were enrolled as normal control group.The healing of gastric ulcer was observed under white light endoscopy.The morphological changes of gastric pits and microvessel of mucosal at peripheral mucosa around ulcer and normal gastric mucosal were observed under narrow band imaging magnifying endoscopy.The gastric mucosa tissues of the two groups before and after treatment,and normal gastric mucosa of healthy control group were taken.The amount of deposition and composition of collagen fibers,the expression level of factor Ⅷ,the level of transforming growth factor (TGF)-beta1 and the content of hydroxyproline were analyzed by Masson,immunofluorescent and immunohistochemistry staining as well as enzyme linked immunosorbent assay.Chi square test,one-way analysis of variance (ANOVA),least significant difference (LSD) method,Dunnett's T3 and Kruskal-Wallis test and other method were used for comparison.Results After treatment,18 patients of combination therapy group (21 patients) had regular microvessel nets (85.7％),which was significantly more than those of single therapy group (12 cases,57.1％) and healthy control group (10 cases,47.6 ％),and the differences were statistically significant (x2 =4.200,P=0.040).In the comparison of maturity of regenerative mucosa between combination therapy group and single therapy group after treatment,the ration between collagen type Ⅰ and Ⅱ,deposition of collagen fibers,the number of factor Ⅷ positive cells,the level of TGF-beta1 and the content of hydroxyproline were 36.05 and 23.14;269 375.63.± 171 608.63 and 137 693.14±98 330.93;34.91±8.40 and 28.24±6.93;104 498.71±40 487.96 and 70 757.11±19 323.95;(1 897.80±879.35) and (1 230.57±536.05) μg/L,respectively;while in healthy control group,the above parameters were 36.81,245 696.90 ± 224 687.00,23.10 ± 8.40,94 048.04 ±41 306.55 and 1 681.20 ± 423.61 μg/L,and the differences were statitically significant among these three groups (H=7.375,F=3.465,11.680,5.190,5.160;all P＜0.05).Those parameters of combination therapy group were significantly higher than those of single therapy group (H=2.416,LSD method;all P＜0.05).Conclusion Hydrotalcite combined with esomeprazole in the treatment of gastric ulcer could significantly improve microvessel morphology,maturity degree of regenerative mucosal structure and function,and the mucosal healing quality was also superior to single esomeprazole group.

Endoscopic treatment for gastrointestinal submucosal tumor：A clinical analysis of 94 patients / 实用医学杂志

Objective To discuss the indication, technique, effect, and safety of endoscopic treatment of SMT in gastrointestinal tract. Methods Endoscopic therapy was performed in 94 patients with gastrointestinal diagnosed by endoscopy. 22 cases underwent EMR; 61 cases were treated with ESD; MBM was exercised on 7 cases; and nylon endoloop ligature were carried out on 4 cases. Results Complete resection was achieved on 86 cases, and 1 case was excised partially. 1 patient with SMT was transferred to open surgery. Lumps of 4 SMT cases treated by nylon endoloop ligature were found disappeared at subsequent visit after a month. All patients were followed up for one year, and no recurrence was found. Conclusions Gastrointestinal SMT can be completely resected by EMR, ESD and MBM. Nylon endoloop ligature can be used for the treatment of SMT in position difficult to deal with. Endoscopic therapy is relatively safe, effective, and minimal invasion for SMT.

Clinical observation on the treatment of idiopathic hyperprolactinemia infertility by self-designed Bushen Shugan decoction combined with bromocriptine / 国际中医中药杂志

Objective To evaluate the clinical efficacy of the treatment of idiopathic hyperprolactinemia infertility by Chinese medicine combined with bromocriptine.Methods 80 patients diagnosed of idiopathic hyperprolactinemia infertility were randomly recruited into a control group and a experimental group.The control group was treated with bromocriptine alone and the experimental group was treated additionally with self-designed Bushen Shugan decoction on the basis of the control group.The improvement of the clinical symptoms and follicular development were compared between the two groups.The data of ovulation and pregnancy rate was collected.The serum prolactin level and pregnancy outcomes afterdrug withdrawal was followed up and the recurrences was evaluated.Results The follicular development of the experimental group was improved greatly.Its ovulation rate was 72.5％(29/40),pregnancy rate was 60.0％ (24/40) and recurrence rate was 10.0％ (4/40).The follicular development of the control group was not obvious.Its ovulation rate was 27.5％(11/40),pregnancy rate was 20.0％(8/40)and recurrence rate was 35.0％ (14/40).The difference between the two groups was statistically significant (x2＝ 16.200,13.333,7.168,P＜0.05).Besides,there was no miscarriage,premature delivery and fetal malformations in the experimental group.Conclusion The treatment of idiopathic hyperprolactinemia infertility by Chinese medicine combined with bromocriptine had the characteristics of sound clinical efficacy,little side effect,high ovulation and pregnancy rate,low recurrence and good pregnancy outcomes.

Efficacy of stent smplantation using a rapid artificial cardiac pacing technique on ostial lesions of left anterior descending artery / 中国综合临床

Objective To evaluate the safety and clinical efficacy of stent implantation using a rapid artificial cardiac pacing technique on ostial lesions of left anterior descending artery (LAD).Methods From Jun 2008 to Nov 2010,38 patients with ostial lesions of LAD were recruited and randomly divided into two groups:patients with stent implantation using a rapid artificial cardiac pacing technique (pacing group,n =19 ) and patients with direct stent implantation (no-pacing group,n =19 ).Post-stenting examination was performed.Patients were followed-up for 9 months and coronary angiography was reviewed.The immediate success rate,major adverse cardiac events including death,reinfarction and target vessel revascularization,late lumen loss,sent thmmbosisin,rent-restenosis were compared between these two groups.Results There were no significant differences in the baseline values,disease characteristics and instant response to surgery between pacing and no-pacing groups(P ＞ 0.05 ).The time cost for stent placement was significantly shorter in the pacing group than that in the no-pacing group ( [ 16.5 ± 0.5 ] s vs.[46.6 ± 1.4 ] s,t =88.256,P =0.004 ).After surgery,there was no acute or subacute thrombosis,in-stent restenosis or occlusion for patients in the pacing group.In the no-pacing group,one patient developed acute thrombosis.The symptoms disappeared after thrombus aspiration and balloon dilatation by emergency percutaneous coronary intervention.Patients were followed up for 270 -275 days,and patients in the pacing group received post-stenting coronary angiography 9 months after stent implantation using a rapid artificial cardiac pacing technique,and no in-stent re-stenosis was found.During this period,nobody had adverse events such as death,myocardial infarction or target lesion revascularization,while five cases with in-stent restenosis (50％ -60％ )were found in the no-pacing group,without further target lesion reconstruction due to symptomless.Conclusion Compared with previous positioning technique,stent implantation using a rapid artificial cardiac pacing technique on treatment of ostial lesions of LAD is safer,and more effective.It is a favorable method for accurate positioning of bracket and can improve the prognosis,reduce the occurrence of acute thrombosis and in-stent restenosis.

Predictive value of rectal aberrant crypt foci for colorectal cancer and progressive adenoma and its risk factors / 中华消化内镜杂志

Objective To investigate the predictive value of rectal aberrant crypt foci(ACF)for colorectal cancer(CRC)and progressive adenomas, and to analyze its risk factors.Methods IndependentSample T test, One-Way ANOVA and Chi-square test were used to analyze the mean number and incidence of rectal ACF.Logistic regression analysis was used to assess the predictive value of rectal ACF for progressive adenomas and CRC, and to identify the independent risk factors of ACF.Results Large number of ACF, i.e.more than 5, was a significant risk factor for CRC and progressive adenomas.Age and smoking were both risk factors of ACF, while aspirin was a protective factor.Conclusion ACF of more than 5 is predictive of CRC and progressive adenomas.For prevention of CRC, great importance must be attached to risk factors of ACF.

Rate and risk factors of missed diagnosis of colorectal adenoma with colonoscopy / 中华消化内镜杂志

Objective To investigate the miss rate of adenoma with colonoscopy and assess the features and risk factors for missed diagnosis.Methods Patients with colorectal adenoma received a second colonoscopy within 120 days after adenoma was detected and removed on the initial colonoscopy.The findings of two colonoscopies were reviewed and analyzed.The features of adenoma (including size, location, shape, number and pathology) , clinical characteristics of patients (including age, sex, reasons of colonoscopy, history of diverticular disease, history of abdominal or pelvic surgery and colonoscopy with sedation) and endoscopists were recorded.Miss rate and features of different types of missed adenoma were analyzed.We also assessed the effects of adenoma features, patients' characteristics and endoscopists on missed diagnosis of adenoma.Results Adenoma missed diagnosis was found in 271 patients out of 809 recruited subjects (33% ).A total of 425 adenomas were missed out of 2134 (20% ) adenomas detected by repeated colonoscopy.A large diameter was associated with a decrease in the miss rate for adenoma (P < 0.01).Conversely , sessile or flat shape (P < 0.01) , locations at sigmoid, hepatic flexure, cecum and ascending colonic ( P < 0.05) were significantly associated with a higher miss rate of adenoma, as was the number of adenomas (P <0.01).A higher adenoma missed diagnosis rate was observed in beginner colonoscopists, as compared with experienced ones (P < 0.01).Conclusion A marked miss rate of adenoma exists on colonoscopy, which is significantly associated with the size, shape, location and number of adenomas and endoscopists.