Diagnostic Errors ; Humans ; Inflammation ; diagnosis ; etiology ; Laryngeal Neoplasms ; surgery ; Male ; Middle Aged ; Papilloma ; surgery ; Pneumonia ; diagnosis ; Postoperative Complications ; diagnosis

Objective To investigate the effects of simethicone on the quality of video capsule endoscopy (VCE) examination.Methods A prospective study was performed in 90 patients received VCE examination from February 2010 to October 2014.The randomized table was set according to different dosage of simethicone the patients received,by which patients were divided into three groups.Group 1 (35 cases) received 15 mL simethicone,group 2 (30 cases) received 30 mL simethicone and control group (25 cases) received no simethicone.The small intestinal visualization quality of VCE was scored by segments.Segment A was proximal small intestine (one hour after VCE passing pylorus).Segment B was distal small intestine (one hour before VCE passing ileocecal valve).Segment A and B were scored according to the air bubbles and degree of cleanliness.Gastric transit time,small bowel transit time and VCE completion rate were recorded.Student's t test,Mann Whitney rank sum test and chi square test were performed for statistical analysis.Results The average scores of segment A of group 1,group 2 and control group were 0.58,0.33 and 1.67,respectively,and the average socres of segment B were 0.25,0.00 and 1.17,respectively.The lesion detection rates of group 1,group 2 and control group were 68.6％ (24/35),80.0％ (24/30) and 52.0％ (13/25),respectively,and the differences was statistically significant (x2 =8.238,P=0.016).The detection rate of group 2 was significantly higher than those of group 1 and control group (x2 =7.354 and 9.349,P=0.034 and 0.005).The detection rates of small intestinal erosion of group 1,group 2 and control group were 22.9％ (8/35),70.0％ (21/30) and 32.0％ (8/25),respectively,and the differences was statistically significant (x2=8.714,P=0.013).The detection rate of group 2 was significantly higher than those of group 1 and control group (x2 =10.600 and 7.380,P=0.005 and 0.025).There was no statistically significant difference in the detection rates of ulcer,vascular malformation and protrusion among the three groups (all P＞0.05).The detection rates of lesions＜0.5 cm of group 1,group 2 and control group were 37.1％ (13/35),66.7％ (20/30) and 32.0％ (8/25),respectively,and the differences was statistically significant (x2 =8.242,P=0.016).The detection rate of group 2 was significantly higher than those of group 1 and control group (x2 =9.250 and 7.842,P =0.011 and 0.017).Conclusion Oral adminstration of 30 mL simethicone could obviously decrease air bubbles in small intestine,and increase lesion detection rate of VCE.

SUMMARY Behcet’sdisease(BD)isachronicvascularinflammatorydiseaseofunknowncauses.Itis called intestinal BD,when digestive tract is involved.To investigate small bowel feature of intestinal BD, we now report 5 intestinal BD cases undergone capsule endoscopy from December,2010 to April,2014 in Peking University People’s Hospital.General information,clinical feature and endoscopic feature were presented,and literatures were reviewed.There were 3 male and 2 female patients.Age range was from 23 to 55 years old (median age 40 years old).Disease course was from 3 days to 28 years (median course 9 years).4 patients were diagnosed as systemic BD,and the rest independent intestinal BD.4 systemic BD patients all presented as recurrent oral aphthous as initial symptom and had history of vulvar ulcer and skin lesion.They all had gastrointestinal symptoms,including retrosternal pain (2 cases),he-matochezia (3 cases),diarrhea (3 cases)and abdominal pain (2 cases).1 patient had a history of fis-tula of ileocecal junction and underwent caecectomy.5 patients all underwent whole digestive tract exami-nation by endoscopy,including gastroscopy,colonoscopy and capsule endoscopy.Except of 1 normal re-sult of colonoscopy,all endoscopy results revealed lesions.Capsule endoscopy results of all patients were abnormal.Types of small intestinal lesion were various,including ulceration,erosion,protrusion and vasculopathy.All digestive tract can be involved in BD patients.Capsule endoscopy can evaluate lesions throughout whole digestive tract,especially in small intestine.As a consequence,it is helpful to explain gastrointestinal symptom,increase early diagnostic rate.Intestinal BD (IBD)mainly involves small bow-el,and ileum is the major involved segment,not only limited in ileocecum.The updated perspective of IBD lesion distribution will contribute to differential diagnosis between IBD and Crohn’s disease.This is the first time to report capsule endoscopic feature of BD patients in China.

Objective To explore the causes of congenital hypothyroidism by single photon emission computed tomography(SPECT) thyroid imaging.Methods Nineteen cases with congenital hypothyroidism were collected,and SPECT thyroid imaging was performed 15 minutes late after injected 99m TcO_ 4- 18.5-37.0 MBq.Results Five cases were found with normal glands,1 case with enlarged thyroid, 2 cases with enlarged thyroid and increased radiation,4 cases with ectopic thyroid,4 with a hypogenetic thyroid,and the last 3 cases showed no thyroid imaging.Conclusions The causes of congenital hypothyroidism can be found by SPECT thyroid imaging,which is important to the diagnosis of congenital hypothyroidism combined with detection of T_3,T_4,TSH.

Cardia ; pathology ; surgery ; China ; epidemiology ; Esophageal Neoplasms ; diagnosis ; epidemiology ; surgery ; Esophagectomy ; Esophagoscopy ; Gastroscopy ; Humans ; Mass Screening ; Minimally Invasive Surgical Procedures ; Precancerous Conditions ; diagnosis ; surgery ; Stomach Neoplasms ; diagnosis ; epidemiology ; surgery

To study the effect of Gegen Qinlian decoction and its major effective components on five hepatic microsomal CYP450 isozymes in rats. The in vitro hepatic microsomal incubation technique was used to co-culture Gegen Qinlian decoction and its major effective components together with each probe substrate. HPLC-MS/MS was used to establish the analytical method for metabolites of the five isoform probe substrates of CYP450 isozymes, detect the linearity among micoromal protein concentration, incubation time and metabolite formation amount. And HPLC-MS/MS was applied to determine the formation rate (V) of corresponding metabolites (acetaminophen, 4-OH-chlorzoxazone, dextrophan, 6-OH-chlorzoxazone and 6β-hydroxytestosterone) specific probe substrates of the five isoform probe substrates of CYP450 isozymes (phenacetin, polbutamide, dextromethorphan, chlorzoxazone, testosterone), in order to determine the activity of each isozyme. The result showed good linearity among acetaminophen, 4-OH-tolbutamide, dextrophan, 6-OH-chlorzoxazone and 6β-hydroxytestosterone, satisfactory precision, stability and average recovery, suggesting the method was feasible. The optimized in vitro microsomal incubation conditions conformed to the requirements in the guideline of drug-drug interaction. Gegen Qinlian decoction showed different degrees of inhibitor effect on 5 CYP450 isoforms (CYP1A2, CYP2C11, CYP2D2, CYP2E1, CYP3A1/2). Its major effective component berberine could inhibit each CYP450 isoform at high concentrations (except for CYP1A2, CYP3A1/2).
Animals ; Chromatography, High Pressure Liquid ; methods ; Cytochrome P-450 Enzyme Inhibitors ; pharmacology ; Drugs, Chinese Herbal ; pharmacology ; Isoenzymes ; antagonists & inhibitors ; Liver ; enzymology ; Rats ; Tandem Mass Spectrometry ; methods

Objective To investigate the role of intestinal fatty acid binding protein (IFABP) and blood procalcitonin (PCT) in diagnosis of traumatic Intestinal rupture in early stage.Methods The clinical data of 58 patients with abdominal injuries admitted from May 2012 to April 2016 were retrospectively analyzed.All 58 patients were divided into intestinal rupture group (n =21) and nonintestinal rupture group (n =37).The concentrations of IFABP and PCT were detected,analyzed and compared between two groups at different intervals.Results The IFABP and PCT in intestinal rupture group were significantly higher than those in non-intestinal rupture group.The IFABP and PCT in intestinal rupture group significantly decreased after operations.There were significantly differences in IFABP and PCT between two groups at admission,4 hours after admission,preoperative period,and 24 hours after operation.However,these differences disappeared at 72 hours after operation.At the same time,the accuracy rate 92.4％,sensitivity 96.3％,specificity 72.8％ found in combination of these two biomarkers were significantly higher than those of IFABP and PCT measured separately.Conclusions The combination of IFABP and PCT detection can be used as an indicator for the diagnosis of traumatic intestinal rupture in the early stage.

OBJECTIVEIn order to accurately reconstruct the acoustic source image, the application of transducer's receiving characteristics in magneto-acoustic tomography with magnetic induction (MAT-MI) is studied.

METHODSThe conductivity phantom model is built, and the magnetic acoustic signals are simulated and the acoustic sources are reconstructed according to the transducer's receiving characteristics.

RESULTSThe reconstructed image of acoustic source is consistent with the topographic shape and size of the phantom model.

CONCLUSIONMAT-MI based on the transducer's characteristics lays the foundation for further study.

Acoustics ; Magnetic Phenomena ; Magnetics ; Tomography ; Transducers

OBJECTIVETo explore the clinical effects of PLIF surgery for elderly patients with lumbar degenerative disease.

METHODSFrom March 2010 to May 2013, 28 patients with lumbar degenerative disease, aged more than 80 years were treated with PLIF surgery. There were 10 males and 18 females, aged from 80 to 93 years old with an average of (85.44±3.66) years. Course of disease was from 3 to 20 years. The operation time, intra-operative blood loss, operation complications were recorded and JOA scores and Macnab criteria were used to evaluate the clinical outcomes.

RESULTSAll patients were followed up from 12 to 40 months with an average of 26.5 months. The average operation time was (150.00±26.42) min and the average intra-operative blood loss was (373.33±99.88) ml. The pre-operative JOA score was 12.30±2.43, and the corresponding postoperative JOA score at the final follow-up was 24.81±2.09 which was much higher than the preoperative one (P<0.01). According to the modified Macnab criteria to evaluate at the final follow-up, 16 patients got an excellent result, 10 good, 2 fair. In the weeks postoperatively, injuries of nerve root happened in 3 cases, superficial wound infection with delayed healing in 3 cases, and tear of the dural sac accompanied with cerebrospinal fluid leakage in 1 case. After long term follow-up, adjacent segment degeneration and the corresponding spinal canal stenosis occurred in 1 case at 34 months after operation. All cases got successful fusion without any displacement of internal fixation and pseudoarthrosis formation.

CONCLUSIONWith proper cases, fully preoperative preparation, perfect intra-operative manipulation and active treatment after operation, even advanced ages older than 80 years with lumbar degenerative disease could get satisfactory outcomes after PLIF surgery.

Aged ; Aged, 80 and over ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Operative Time ; Spinal Diseases ; surgery ; Spinal Fusion ; methods

Objective To study the characteristics and clinical features of positive response during head - up tilt test (HUT) in children. Methods Forty- nine cases of syncope and aura of syncope were included in the study. All of them underwent HUT (tilt angle 60 degree,lasting 45 minutes). During the test,children' blood pressure,heart rate.electrocardiography and clinical symptoms and signs were dynamically observed. Results The common syncope aura symptoms were headache, dizziness, chest distress, difficulties in breathing, pale, perspiration, blurred vision, auditus depression and symptoms related to digestive symptoms. Among the 28 positive cases, 7 cases were of vaso - inhibitory pattern (25%), with a decrease in blood pressure and an increase in heart rate, 3 cases inhibitory pattern (11%), with a decrease in heart rate but withoilt'blood pressure changes, 4 cases mixed pattern (14 %), with decreases in heart rate and blood pressure obviously, 10 eases POTS (36%), with an increase in heart rate by 30 bpm or up to 120 bpm within 10 minutes while testing, and 4 cases orthostatic hypotension (14%), with a decrease in blood pressure within 3 minutes. Conclusion HUT can be regarded as the main tool in differential diagnosis of unexplained syncope in children.