Objective To observe the clinical effect of different doses of simethicone on the colonoscopy bowel preparation.Methods One hundred and fifty outpatients who received colonoscopy were randomly divided into three groups:group A1 (PEG plus 5 ml simethicone),group A2 (PEG plus 10 ml simethicone) and group B (PEG =polyethylene glycol electrolyte).The colonic cleaness,effect of removing bubbles,total procedure time,patients' satisfaction and tolerance were observed during the examination.Results The satisfaction with bubbles removal were 98.0％ (49/50),100.0％ (50/50) and 80.0％ (40/50) with significant difference(x2 =17.855,P =0.000).However,there was no difference in cleaness (x2 =1.500,P =0.472),total procedure time (Z =-0.333,P =0.765),patients' satisfaction (x2 =6.303,P =0.178) and tolerance (x2 =8.238,P =0.083).Conclusion Simethicone is of benefit for colonoscopic bowel preparation in removing air bubbles,which can enhance visibility.Five ml dose of simethicone can meet the basic need of removing air bubbles,and 10 ml dose of simethicone can exert better effects.

Objective To compare the differences between antrum and corpus in endoscopic and histological diagnosis in non-ulcer dyspeptic patients.Methods 132 cases from out-patient department who had been ordered to undergo gastroendoscopy for dyspepsia were enrolled in the study.After endoscopy,different signs including redness,erosion,intramural bleeding and rugal atrophy were described.Histological diagnosis was defined according to the classification of chronic inflammation,polymorphonuclear neutrophil activity,glandular atrophy,intestinal metaplasia,helicobacter pylori and dysplasia.The differences between antrum and corpus in endoscopic and histological diagnosis were analyzed.Results Redness and erosion under endoscopy,glandular atrophy and chronic inflammation in histological diagnosis were found more frequently in antrum than in corpus.P values were less than 0.001,0.01,0.001 and equaled to 0.025 respectively.Conclusion In functional dyspeptic patients,there are differences in the endoscopic and histological findings between antrum and corpus.Redness and erosion in endoscopic diagnosis,glandular atrophy and chronic inflammation in histological diagnosis are more common in antrum when compared with that in corpus.

The dominant position of Bundeswehr makes its field medical equipment representative in European troops.With a history more than 50 years,Bundeswehr's field medical equipment passes through 4 phases and has evolved into a complete system,which adopts backpacks,chests,vehicles and containers as the main carrier to adapt to different requirements of field medical service.Bundeswehr's field medical equipment is gifted with such tendencis as high mobility and informatization level.

Objective To compare the anti-hemorrhage effect and safety of hemocoagulase and epinephrine (1∶10 000) during endoscopic mucosal resection (EMR) or polyps electrocautery. Methods Between April and November 2007,totally 60 patients received EMR or endoscopic piecemeal mucosal resection (EPMR) in our hospital because of local lesions in the esophagus,stomach or colon. The patients were randomly divided into hemocoagulase and epinephrine groups (30 cases in each) before receiving the operation. After the resection,the hemorrhage at the surgical area was measured. During the operation,the blood pressure,heart rate,and adverse effects including palpitation,dizziness,pain,and nausea were recorded. Results Immediate hemorrhage was detected in 1 case of hemocoagulase group (1/30,3%),and 6 cases of epinephrine group (6/30,20%,?2=2.588,P=0.108). No hemorrhage was observed at 24 hours in both the groups. No significantly difference was noticed in the injection volume between the two groups [(11.0?6.0) ml (5-30 ml) in hemocoagulase group vs. (11.9?7.0) ml (5-28 ml); t=-0.535,P=0.595]. In epinephrine group,the mean artery blood pressure and heart rate increased significantly after the injection [(96.9?7.9) mm Hg vs. (99.9?8.1) mm Hg,t=-3.005,P=0.005; 79.8?7.9/min vs. 84.3?8.1/min,t=-3.585,P=0.001]. Whereas,no such differences were noticed in hemocoagulase group. Five cases in epinephrine group showed transient dizziness and palpitation,and 2 patients who had esophageal lesions complained of pain at the injection site. None of the hemocoagulase group had postoperative complications. Conclusions Hemocoagulase shows same anti-hemorrhage effect as epinephrine during EMR without leading to adverse effect.

Objective To explore the safety and efficacy of endoscopic retrograde cholangiopancreatography(ERCP)by using carbon dioxide for malignant biliary obstruction.Methods A total of 60 patients with malignant biliary obstruction, hospitalized from September 2008 to February 2010, were randomly divided into 3 groups to receive ERCP by using carbon dioxide, contrast agent or magnetic resonance cholangiopancreatography(MRCP)without any agent.The safety and efficacy of 3 contrast methods were compared.Results Successful stent or drainage tube insertion was achieved in all patients.Carbon dioxide was superior to contrast agent in terms of lowering postoperative infection rate(P ＜ 0.05), and it was also superior to MRCP for more effective drainage(P ＜ 0.05).There was no significant difference in occurrence of postoperative pancreatitis and hyperamylasemia between 3 groups.Conclusion Using carbon dioxide during ERCP, safe and effective, is superior to use of contrast agent in less leukocyte increase, and to MRCP in more adequate drainage in patients with malignant biliary obstruction.Furthermore, there is no more risk of pancreatitis and hyperamylasemia.

Objective To evaluate the clinical utility of SpyGlass single-operator ERCP-guided cholangiopancreatoscopy system for the diagnosis and treatment of bile duct disorders.Methods A total of 9 patients with biliary diseases were treated with SpyGlass single-operator ERCP-guided cholangiopancreatoscopy system.Four patients with large bile duct stones accepted laser lithotripsy,and stones were removed by ERCP.Five patients with indeterminate bile duct stricture accepted cholangioscopy-guided sampling.All patients underwent ENBD,routine blood test,blood amylase test,oral food and water restriction,acid suppression and prophylactic antibiotics.Results SpyGlass was successful in all patients with a manipulating time of 21.2min and total procedure time of 46.2min.Complete stone clearance was achieved in all 4 patients with large biliary stones.Sample quality was adequate in all patients with bile duct stricture with 2 patients diagnosed as having malignant biliary tumor and 3 as inflammatory bile duct stenosis.Post-ERCP complications including mild pancreatitis in 2 patients,and the patients recovered gradually after corresponding treatment.Conclusion ERCP-guided cholangiopancreatoscopy with the SpyGlass system is technically feasible and can be successfully and safely performed in patients with biliary disorders.

Objective To study the independent risk factors of early rebleeding after endoscopic variceal ligation (EVL) and/or endoscopic injection of fibrin tissue adhesive.Methods Data of 370 patients who had cirrhosis and accepted 396 procedures of EVL and/or endoscopic injection of fibrin tissue adhesive were retrospectively studied.Independent risk factors for early rebleeding were determined by Logistic regression analysis.Results Results of all the factors that were significantly different between the re-bleeding and non-rebleeding patients,the portal vein diameter,ascites volume,Child-Pugh score and serum albumin were independent ones of early rebleeding after EVL and/or endoscopic injection of fibrin tissue adhesive ( P ＜ 0.05).Larger volume of ascites,wider portal vein diameter,reduced albumin,Child-Pugh score greater than 10 were indicative factors of rebleeding.Conclusion The early rebleeding rate after EVL and/or endoscopic injection of fibrin tissue adhesive is determined by portal vein diameter,ascites volume,ChildPugh score,and serum albumin.

Objective To evaluate the clinical efficacy of endoscopic variceal ligation (EVL) combined with injection of tissue adhesive for esophageal and gastric varices bleeding.Methods Data of 452 patients with esophageal and gastric varices bleeding who received EVL and injection of tissue adhesive were retrospectively studied.Results The instant hemostatic rate was 100.0％ (145/145).Early rebleeding rate was 1.8％ (8/452).Incidence of early adverse reactions was 50.0％ (226/452).The total incidence rate of complications was 12.4％ (56/452).Efficiency and effectiveness of EVL were 32.5％ (145/446)and 40.4％(180/446) respectively.Efficiency and effectiveness of injection of tissue adhesive were 32.5％ (136/419) and 27.4％ (115/419) respectively.With an average of 18 months' follow-up (ranging from 9 to 37 months),the rate of rebleeding was 10.1％ (43/426),six-month and one-year survival rate was 97.9％ (417/426) and 89.9％ (383/426) respectively.Conclusion EVL combined with injection of tissue adhesive for esophageal and gastric varices is effective,convenient,and less invasive.They can be used not only for emergency hemostasis but also for secondary prophylaxis.

Objective To investigate the oxalate-degrading abilities of 10 strains of lactic acid bacteria for yoghourt fermentation. Methods Ten different strains of lactic acid bacteria (L.acidophilus, L.paracasei, Enterococcaceae faecium, B. lactis, B. adolescentis, B. infantis, B.longum, Lactococcus lactis subsp. Cremori, L.bulgaricus and S. thermophilus) were cultured separately in culture fluid containing 5 mmol/L oxalate. Seventy-two hours after culture, the concentrations of oxalate and lactic acid bacteria were detected. Besides, blank control cultured without lactic acid bacteria was established. Results Seventy-two hours after culture, the concentrations of all the 10 strains of lactic acid bacteria were significantly higher than those before culture (P<0.01). Compared with blank control, the concentrations of oxalate in the culture fluid with 10 strains of lactic acid bacteria decreased 72 h after culture, and were significantly different from those before culture for L.acidophilus, Lactococcus lactis subsp. Cremori, B.longum, B. adolescentis and B. lactis (P<0.05 or P<0.01). The oxalate-degrading rate of B. lactis was the highest (29.03%), and that of Enterococcaceae faecium was the lowest (0.23%). The correlation analysis revealed that there was no significant correlation between times of proliferation and oxalate-degrading rates (r=0.435 7, P=0.208 2). Conclusion All of the 10 strains of lactic acid bacteria for yoghourt fermentation have the ability of oxalate degrading, and there is no correlation between lactic acid bacteria proliferation and oxalate degradation.

Objective To compare the effects of kidney calcium oxalate calculus resistant acidophilus milk (KCOCRAM) versus commercially available acidophilus milk (CAAM) on urinary oxalate excretion in rats. Methods Fifty SD rats were randomly divided into 5 groups (n=10), and were bred with KCOCRAM (KCOCRAM group), CAAM (CAAM group), sterilized KCOCRAM (sterilized KCOCRAM group), sterilized CAAM (sterilized CAAM group) and water (blank control group), respectively for a consecutive 20 d, with 4 mL/d for each rat. The data of body weight and 24 h urinary oxalate excretion volume were obtained 1 d before breeding and every 4 d during breeding. Results During breeding, body weight and 24 h urinary oxalate excretion volume of each group increased with time. There was no significant difference in urinary oxalate excretion volume among sterilized KCOCRAM group, sterilized CAAM group and blank control group (P>0.05). The increase tendency of KCOCRAM group and CAAM group was weaker than that of the other three groups. The urinary oxalate excretion volume was significantly lower in KCOCRAM group than that in sterilized KCOCRAM group from 8 d after breeding, and that was significantly lower in CAAM group than that in sterilized CAAM group from 12 d after breeding (P<0.05). The urinary oxalate excretion volume was significantly lower in KCOCRAM group than that in CAAM group from 16 d after breeding (P<0.05). There was a positive correlationship between body weight and 24 h urinary oxalate excretion volume in each group (r＝0.97-0.99, P<0.01). Conclusion Both KCOCRAM and CAAM can reduce urinary oxalate excretion in rats, and the former has a more favourable effect.