目的:探究他克莫司联合窄谱UVB治疗特应性皮炎的疗效。方法:选取2021年2月-2022年12月笔者医院就诊120例的特应性皮炎患者,并按照简单随机化随机分为A组(采用他克莫司治疗,40例)、B组(采用润肤霜联合窄谱UVB治疗,40例)和C组(采用他克莫...目的:探究他克莫司联合窄谱UVB治疗特应性皮炎的疗效。方法:选取2021年2月-2022年12月笔者医院就诊120例的特应性皮炎患者,并按照简单随机化随机分为A组(采用他克莫司治疗,40例)、B组(采用润肤霜联合窄谱UVB治疗,40例)和C组(采用他克莫司联合窄谱UVB治疗,40例),持续治疗2个月。于治疗前、治疗1个月和治疗2个月后,比较三组特应性皮炎患者的临床体征[特应性皮炎评分量表(Scoring atopic dermatitis index,SCORAD)、中文版特应性皮炎控制工具量表(Chinese version of atopic dermatitis control tool,ADCT)]、瘙痒情况[峰值瘙痒数字评定量表(Peak pruritis-numerical rating scale,PP-NRS)]、细胞因子[血清载脂蛋白A1(Apolipoprotein A1,ApoA1)、载脂蛋白B(Apolipoprotein B,ApoB)、白细胞介素4(IL-4)、白细胞介素10(IL-10)]水平、美学效果[皮炎整体面积、客观体征评分(红斑、表皮剥脱、苔藓样变)]和生活质量[皮肤病生活质量量表(DLQI)]。记录治疗期间三组患者的不良反应,比较其治疗后3个月随访期间复发情况。结果:治疗1个月和治疗2个月后,三组的SCORAD、ADCT、PP-NRS、ApoB、IL-4、IL-10、皮炎整体面积、进行客观体征评分和DLQI评分均较治疗前显著下降,且C组显著低于A组和B组(均P<0.05);三组的ApoA1均较治疗前显著提高,且C组显著高于A组和B组(均P<0.05)。治疗期间,三组患者的不良反应发生率无显著差异(P>0.05);治疗后3个月随访期间,C组的复发情况显著低于A组和B组(P<0.05)。结论:他克莫司联合窄谱UVB治疗在特应性皮炎患者中具有显著的治疗效果,能够有效地缓解特应性皮炎症状和瘙痒情况,改善患者生活质量,提升美学效果。展开更多
目的:观察司库奇尤单抗联合窄谱中波紫外线(UVB)照射治疗中重度斑块型银屑病疗效及对患者银屑病面积和严重程度指数(Psoriasis area and severity index,PASI)评分及血清免疫球蛋白、炎症因子的影响。方法:选取2021年1月-2023年7月笔者...目的:观察司库奇尤单抗联合窄谱中波紫外线(UVB)照射治疗中重度斑块型银屑病疗效及对患者银屑病面积和严重程度指数(Psoriasis area and severity index,PASI)评分及血清免疫球蛋白、炎症因子的影响。方法:选取2021年1月-2023年7月笔者医院皮肤科就诊的80例中重度斑块型银屑病患者,按随机数字表法分为观察组和对照组各40例。对照组予以窄谱UVB照射治疗,观察组予以司库奇尤单抗联合窄谱UVB照射治疗。两组患者均治疗观察12周,评价临床疗效、治疗前后PASI及皮肤病生活质量指数(Dermatology life quality index,DLQI)评分;检测患者血清免疫球蛋白(IgE、IgA、IgG)及白介素-17(IL-17)、白介素-23(IL-23)、肿瘤坏死因子-α(TNF-α)水平,记录不良反应情况。结果:治疗后,观察组总有效率95.00%,高于对照组的80.00%(P<0.05)。治疗后,两组患者PASI、DLQI评分均较治疗前下降,且观察组PASI、DLQI评分均较对照组低(P<0.05)。治疗后,两组患者血清IgE、IgA、IgG及IL-17、IL-23、TNF-α水平均较治疗前下降,且观察组血清IgE、IgA、IgG及IL-17、IL-23、TNF-α水平均较对照组低(P<0.05)。观察组不良反应总发生率15.00%,与对照组的7.50%比较差异无统计学意义(P>0.05)。结论:司库奇尤单抗联合窄谱UVB照射治疗中重度斑块型银屑病,相较单独窄谱UVB治疗效果更佳,有助于减轻症状、调节免疫功能、抑制炎症水平,对提高患者生活质量有积极意义,且未明显增加不良反应。展开更多
Objective This study aimed to compare the performance of standard-definition white-light endoscopy(SD-WL),high-definition white-light endoscopy(HD-WL),and high-definition narrow-band imaging(HD-NBI)in detecting colore...Objective This study aimed to compare the performance of standard-definition white-light endoscopy(SD-WL),high-definition white-light endoscopy(HD-WL),and high-definition narrow-band imaging(HD-NBI)in detecting colorectal lesions in the Chinese population.Methods This was a multicenter,single-blind,randomized,controlled trial with a non-inferiority design.Patients undergoing endoscopy for physical examination,screening,and surveillance were enrolled from July 2017 to December 2020.The primary outcome measure was the adenoma detection rate(ADR),defined as the proportion of patients with at least one adenoma detected.The associated factors for detecting adenomas were assessed using univariate and multivariate logistic regression.Results Out of 653 eligible patients enrolled,data from 596 patients were analyzed.The ADRs were 34.5%in the SD-WL group,33.5%in the HD-WL group,and 37.5%in the HD-NBI group(P=0.72).The advanced neoplasm detection rates(ANDRs)in the three arms were 17.1%,15.5%,and 10.4%(P=0.17).No significant differences were found between the SD group and HD group regarding ADR or ANDR(ADR:34.5%vs.35.6%,P=0.79;ANDR:17.1%vs.13.0%,P=0.16,respectively).Similar results were observed between the HD-WL group and HD-NBI group(ADR:33.5%vs.37.7%,P=0.45;ANDR:15.5%vs.10.4%,P=0.18,respectively).In the univariate and multivariate logistic regression analyses,neither HD-WL nor HD-NBI led to a significant difference in overall adenoma detection compared to SD-WL(HD-WL:OR 0.91,P=0.69;HD-NBI:OR 1.15,P=0.80).Conclusion HD-NBI and HD-WL are comparable to SD-WL for overall adenoma detection among Chinese outpatients.It can be concluded that HD-NBI or HD-WL is not superior to SD-WL,but more effective instruction may be needed to guide the selection of different endoscopic methods in the future.Our study’s conclusions may aid in the efficient allocation and utilization of limited colonoscopy resources,especially advanced imaging technologies.展开更多
BACKGROUND Conventional magnifying endoscopy with narrow-band imaging(NBI)observation of the gastric body mucosa shows dominant patterns in relation to the regular arrangement of collecting venules,subepithelial capil...BACKGROUND Conventional magnifying endoscopy with narrow-band imaging(NBI)observation of the gastric body mucosa shows dominant patterns in relation to the regular arrangement of collecting venules,subepithelial capillary network,and gastric pits.AIM To evaluate the effectiveness of a new one-dual(near)focus,NBI mode in the assessment of the microscopic features of gastric body mucosa compared to conventional magnification.METHODS During 2021 and 2022,68 patients underwent proximal gastrointestinal endoscopy using magnification endoscopic modalities subsequently applying acetic acid(AA).The GIF-190HQ series NBI system with dual focus capability was used for the investigation of gastric mucosa.At the time of the endoscopy,the gastric body mucosa of all enrolled patients was photographed using the white light endoscopy(WLE),near focus(NF),NF-NBI,AA-NF,and AA-NF-NBI modes.RESULTS The WLE,NF and NF-NBI endoscopic modes for all patients(204 images)were classified in the same order into three groups.Two images from each patient for the AA-NF and AA-NF-NBI endoscopic modes were classified in the same order.According to all three observers who completed the work independently,NF magnification was significantly superior to WLE(P<0.01),and the NF-NBI mode was significantly superior to NF magnification(P<0.01).After applying AA,the three observers confirmed that AA-NF-NBI was significantly superior to AA-NF(P<0.01).Interobserver kappa values for WLE were 0.609,0.704,and 0.598,respectively and were 0.600,0.721,and 0.637,respectively,for NF magnification.For the NF-NBI mode,the values were 0.378,0.471,and 0.553,respectively.For AA-NF,they were 0.453,0.603,and 0.480,respectively,and for AA-NF-NBI,they were 0.643,0.506,and 0.354,respectively.CONCLUSION When investigating gastric mucosa in microscopic detail,NF-NBI was the most powerful endoscopic mode for assessing regular arrangement of collecting venules,subepithelial capillary network,and gastric pits among the five endoscopic modalities investigated in this study.AA-NF-NBI was the most powerful endoscopic mode for analyzing crypt opening and intervening part.展开更多
文摘目的:探究他克莫司联合窄谱UVB治疗特应性皮炎的疗效。方法:选取2021年2月-2022年12月笔者医院就诊120例的特应性皮炎患者,并按照简单随机化随机分为A组(采用他克莫司治疗,40例)、B组(采用润肤霜联合窄谱UVB治疗,40例)和C组(采用他克莫司联合窄谱UVB治疗,40例),持续治疗2个月。于治疗前、治疗1个月和治疗2个月后,比较三组特应性皮炎患者的临床体征[特应性皮炎评分量表(Scoring atopic dermatitis index,SCORAD)、中文版特应性皮炎控制工具量表(Chinese version of atopic dermatitis control tool,ADCT)]、瘙痒情况[峰值瘙痒数字评定量表(Peak pruritis-numerical rating scale,PP-NRS)]、细胞因子[血清载脂蛋白A1(Apolipoprotein A1,ApoA1)、载脂蛋白B(Apolipoprotein B,ApoB)、白细胞介素4(IL-4)、白细胞介素10(IL-10)]水平、美学效果[皮炎整体面积、客观体征评分(红斑、表皮剥脱、苔藓样变)]和生活质量[皮肤病生活质量量表(DLQI)]。记录治疗期间三组患者的不良反应,比较其治疗后3个月随访期间复发情况。结果:治疗1个月和治疗2个月后,三组的SCORAD、ADCT、PP-NRS、ApoB、IL-4、IL-10、皮炎整体面积、进行客观体征评分和DLQI评分均较治疗前显著下降,且C组显著低于A组和B组(均P<0.05);三组的ApoA1均较治疗前显著提高,且C组显著高于A组和B组(均P<0.05)。治疗期间,三组患者的不良反应发生率无显著差异(P>0.05);治疗后3个月随访期间,C组的复发情况显著低于A组和B组(P<0.05)。结论:他克莫司联合窄谱UVB治疗在特应性皮炎患者中具有显著的治疗效果,能够有效地缓解特应性皮炎症状和瘙痒情况,改善患者生活质量,提升美学效果。
文摘目的:观察司库奇尤单抗联合窄谱中波紫外线(UVB)照射治疗中重度斑块型银屑病疗效及对患者银屑病面积和严重程度指数(Psoriasis area and severity index,PASI)评分及血清免疫球蛋白、炎症因子的影响。方法:选取2021年1月-2023年7月笔者医院皮肤科就诊的80例中重度斑块型银屑病患者,按随机数字表法分为观察组和对照组各40例。对照组予以窄谱UVB照射治疗,观察组予以司库奇尤单抗联合窄谱UVB照射治疗。两组患者均治疗观察12周,评价临床疗效、治疗前后PASI及皮肤病生活质量指数(Dermatology life quality index,DLQI)评分;检测患者血清免疫球蛋白(IgE、IgA、IgG)及白介素-17(IL-17)、白介素-23(IL-23)、肿瘤坏死因子-α(TNF-α)水平,记录不良反应情况。结果:治疗后,观察组总有效率95.00%,高于对照组的80.00%(P<0.05)。治疗后,两组患者PASI、DLQI评分均较治疗前下降,且观察组PASI、DLQI评分均较对照组低(P<0.05)。治疗后,两组患者血清IgE、IgA、IgG及IL-17、IL-23、TNF-α水平均较治疗前下降,且观察组血清IgE、IgA、IgG及IL-17、IL-23、TNF-α水平均较对照组低(P<0.05)。观察组不良反应总发生率15.00%,与对照组的7.50%比较差异无统计学意义(P>0.05)。结论:司库奇尤单抗联合窄谱UVB照射治疗中重度斑块型银屑病,相较单独窄谱UVB治疗效果更佳,有助于减轻症状、调节免疫功能、抑制炎症水平,对提高患者生活质量有积极意义,且未明显增加不良反应。
基金supported by the Beijing Municipal Science and Technology Commission(BMSTC,No.D171100002617001).
文摘Objective This study aimed to compare the performance of standard-definition white-light endoscopy(SD-WL),high-definition white-light endoscopy(HD-WL),and high-definition narrow-band imaging(HD-NBI)in detecting colorectal lesions in the Chinese population.Methods This was a multicenter,single-blind,randomized,controlled trial with a non-inferiority design.Patients undergoing endoscopy for physical examination,screening,and surveillance were enrolled from July 2017 to December 2020.The primary outcome measure was the adenoma detection rate(ADR),defined as the proportion of patients with at least one adenoma detected.The associated factors for detecting adenomas were assessed using univariate and multivariate logistic regression.Results Out of 653 eligible patients enrolled,data from 596 patients were analyzed.The ADRs were 34.5%in the SD-WL group,33.5%in the HD-WL group,and 37.5%in the HD-NBI group(P=0.72).The advanced neoplasm detection rates(ANDRs)in the three arms were 17.1%,15.5%,and 10.4%(P=0.17).No significant differences were found between the SD group and HD group regarding ADR or ANDR(ADR:34.5%vs.35.6%,P=0.79;ANDR:17.1%vs.13.0%,P=0.16,respectively).Similar results were observed between the HD-WL group and HD-NBI group(ADR:33.5%vs.37.7%,P=0.45;ANDR:15.5%vs.10.4%,P=0.18,respectively).In the univariate and multivariate logistic regression analyses,neither HD-WL nor HD-NBI led to a significant difference in overall adenoma detection compared to SD-WL(HD-WL:OR 0.91,P=0.69;HD-NBI:OR 1.15,P=0.80).Conclusion HD-NBI and HD-WL are comparable to SD-WL for overall adenoma detection among Chinese outpatients.It can be concluded that HD-NBI or HD-WL is not superior to SD-WL,but more effective instruction may be needed to guide the selection of different endoscopic methods in the future.Our study’s conclusions may aid in the efficient allocation and utilization of limited colonoscopy resources,especially advanced imaging technologies.
文摘BACKGROUND Conventional magnifying endoscopy with narrow-band imaging(NBI)observation of the gastric body mucosa shows dominant patterns in relation to the regular arrangement of collecting venules,subepithelial capillary network,and gastric pits.AIM To evaluate the effectiveness of a new one-dual(near)focus,NBI mode in the assessment of the microscopic features of gastric body mucosa compared to conventional magnification.METHODS During 2021 and 2022,68 patients underwent proximal gastrointestinal endoscopy using magnification endoscopic modalities subsequently applying acetic acid(AA).The GIF-190HQ series NBI system with dual focus capability was used for the investigation of gastric mucosa.At the time of the endoscopy,the gastric body mucosa of all enrolled patients was photographed using the white light endoscopy(WLE),near focus(NF),NF-NBI,AA-NF,and AA-NF-NBI modes.RESULTS The WLE,NF and NF-NBI endoscopic modes for all patients(204 images)were classified in the same order into three groups.Two images from each patient for the AA-NF and AA-NF-NBI endoscopic modes were classified in the same order.According to all three observers who completed the work independently,NF magnification was significantly superior to WLE(P<0.01),and the NF-NBI mode was significantly superior to NF magnification(P<0.01).After applying AA,the three observers confirmed that AA-NF-NBI was significantly superior to AA-NF(P<0.01).Interobserver kappa values for WLE were 0.609,0.704,and 0.598,respectively and were 0.600,0.721,and 0.637,respectively,for NF magnification.For the NF-NBI mode,the values were 0.378,0.471,and 0.553,respectively.For AA-NF,they were 0.453,0.603,and 0.480,respectively,and for AA-NF-NBI,they were 0.643,0.506,and 0.354,respectively.CONCLUSION When investigating gastric mucosa in microscopic detail,NF-NBI was the most powerful endoscopic mode for assessing regular arrangement of collecting venules,subepithelial capillary network,and gastric pits among the five endoscopic modalities investigated in this study.AA-NF-NBI was the most powerful endoscopic mode for analyzing crypt opening and intervening part.
