AIM: To investigate and evaluate the feasibility of the computer-aided screening diagnosis for enteric lesions in the capsule endoscopy (CE).METHODS: After developing a series of algorithms for the screening diagnosis...AIM: To investigate and evaluate the feasibility of the computer-aided screening diagnosis for enteric lesions in the capsule endoscopy (CE).METHODS: After developing a series of algorithms for the screening diagnosis of the enteric lesions in CE based on their characteristic colors and contours, the normal and abnormal images obtained from 289 patients were respectively scanned and diagnosed by the CE readers and by the computer-aided screening for the enteric lesions with the image-processed software (IPS). The enteric lesions shown by the images included esoenteritis, mucosal ulcer and erosion, bleeding, space-occupying lesions, angioectasia, diverticula, parasites, etc. The images for the lesions or the suspected lesions confirmed by the CE readers and the computers were collected, and the effectiveness rate of the screening and the number of the scanned images were evaluated, respectively.RESULTS: Compared with the diagnostic results obtained by the CE readers, the total effectiveness rate (sensitivity) in the screening of the commonly-encountered enteric lesions by IPS varied from 42.9% to 91.2%, with a median of 74.2%, though the specificity and the accuracy rates were still low, and theimages for the rarely-encountered lesions were difficult to differentiate from the normal images. However, the number of the images screened by IPS was 5000 on average, and only 10%-15% of the original images were left behind. As a result, a large number of normal images were excluded, and the reading time decreased from 5 h to 1 h on average.CONCLUSION: Though the total accuracy and specificity rates by the computer-aided screening for the enteric lesions with IPS are much lower than those by the CE readers, the computer-aided screening diagnosis can exclude a large number of the normal images and confine the enteric lesions to 5000 images on average, which can reduce the workload of the readers in the scanning of the images. This computer-aided screening technique can make a correct diagnosis as efficiently as possible in most of the patients.展开更多
Colon capsule endoscopy (CCE) was first put into clinical practice for the evaluation of the small bowel in patients presenting with a gastrointestinal bleed unsuccessfully diagnosed by upper GI endoscopy and colonosc...Colon capsule endoscopy (CCE) was first put into clinical practice for the evaluation of the small bowel in patients presenting with a gastrointestinal bleed unsuccessfully diagnosed by upper GI endoscopy and colonoscopy. With the recent advent of new technology, there is improved visualization of the intestinal mucosa and subsequently a higher sensitivity for identification of mural pathology, as seen in many recent prospective studies. CCE has now been studied both in the US and in Europe as a modality for colon cancer screening as well as for the diagnosis of inflammatory bowel disease. When compared to conventional colonoscopy, CCE has been shown to have a sensitivity of greater than 88% for identifying 6mm colonic polyps and over 90% for 1 cm polyps. Therefore its use as a screening tool for colon cancer must be evaluated. In patients suspected to have colitis secondary to inflammatory bowel disease (IBD), it has been shown to have 89% sensitivity for identifying active colonic inflammation. For higher risk patients that requiring urgent colonoscopy, CCE offers an attractive alternative with the potential for a reduced risk on iatrogenic injury. Colon capsule endoscopy may also play an important role in the diagnosis and surveillance of IBD with colonic manifestations. Colonoscopy during active severe disease is associated with an increased risk of perforation due to mucosal inflammation and friability, allowing us to consider CCE as a potentially safer alternative. CCE appears to be most useful for patients with acute lower GI bleeding, inflammatory bowel disease, colonic ischemia or other mucosal-based lesions.展开更多
脉血康胶囊(肠溶片)治疗心脑血管疾病具有良好的临床疗效及安全性。在临床医生问卷调查和脉血康胶囊(肠溶片)研究文献系统回顾的基础上,采用国际临床医学专家共识研制方法,基于现有最佳证据,充分结合专家经验,遵循“循证为主,共识为辅,...脉血康胶囊(肠溶片)治疗心脑血管疾病具有良好的临床疗效及安全性。在临床医生问卷调查和脉血康胶囊(肠溶片)研究文献系统回顾的基础上,采用国际临床医学专家共识研制方法,基于现有最佳证据,充分结合专家经验,遵循“循证为主,共识为辅,经验为鉴”的原则,国内26位中西医临床、药学、方法学等多学科专家共同研制该共识,旨在进一步提高临床医生对该药的认识,更好地指导其临床合理用药。共识采用国际公认的证据分级推荐标准即评估、发展和评价建议的分级(Grading of Recommendations Assessment,Development and Evaluation,GRADE分级),如果证据充分则形成“推荐意见”,采用GRADE网格计票规则;如果证据不充分,则形成“共识建议”,采用多数计票规则。共识对脉血康胶囊(肠溶片)用于心脑血管疾病的适应证、用法用量、疗程、禁忌证、合并用药进行了推荐或建议,并完善了安全性信息,为其临床的合理使用提供参考。展开更多
目的建立虎地肠溶胶囊多成分定量方法,并结合化学计量学方法对其进行质量评价。方法采用超高效液相色谱—四极杆静电场轨道阱高分辨质谱法(ultra-performance liquid chromatography-quadrupole-electrostatic field Orbitrap high-reso...目的建立虎地肠溶胶囊多成分定量方法,并结合化学计量学方法对其进行质量评价。方法采用超高效液相色谱—四极杆静电场轨道阱高分辨质谱法(ultra-performance liquid chromatography-quadrupole-electrostatic field Orbitrap high-resolution mass spectrometry,UPLC-Orbitrap-HRMS)测定10批虎地肠溶胶囊中没食子酸、虎杖苷、甘草酸、白藜芦醇、鞣花酸、甘草素、甘草苷、大黄素、绿原酸、异甘草素、咖啡酸、木犀草素、芒柄花素、芹菜素、槲皮素和山柰酚的含量,并采用聚类分析、主成分分析、正交偏最小二乘法判别分析和灰色关联度分析对样品进行综合评价。结果16个成分线性关系良好,专属性、精密度、重复性、稳定性和平均加样回收率实验均符合标准。10批虎地肠溶胶囊被分为2类,甘草素、木犀草素、白藜芦醇、鞣花酸、槲皮素、山柰酚、咖啡酸、绿原酸和大黄素9个成分对样品质量的差异影响较大;以质量优劣情况对样品进行排序,第Ⅰ类样品的质量普遍劣于第Ⅱ类,木犀草素、鞣花酸、槲皮素、山柰酚、绿原酸和大黄素6个成分的含量偏低可能是第Ⅰ类样品质量低劣的原因。结论建立的虎地肠溶胶囊多成分定量方法结合化学计量学分析可用于该药物的质量评价。展开更多
目的探讨溶栓胶囊联合阿司匹林治疗颈动脉硬化斑块的疗效。方法选取100例颈动脉粥样硬化斑块患者作为研究对象,用随机数字表法分为观察组(55例,用溶栓胶囊联合阿司匹林肠溶片治疗)和对照组(45例,用阿司匹林肠溶片治疗)。观察2组治疗后...目的探讨溶栓胶囊联合阿司匹林治疗颈动脉硬化斑块的疗效。方法选取100例颈动脉粥样硬化斑块患者作为研究对象,用随机数字表法分为观察组(55例,用溶栓胶囊联合阿司匹林肠溶片治疗)和对照组(45例,用阿司匹林肠溶片治疗)。观察2组治疗后的临床疗效、斑块情况、中医症状积分、血流变指标和不良反应发生情况。结果治疗后,观察组的临床总有效率(96.36%)高于对照组(80.00%),P<0.05。观察组患者的内-中膜的厚度(intima media thickness,IMT)和斑块面积分别为(0.95±0.16)mm、(19.34±1.47)mm^(2),均低于对照组[(1.24±0.18)mm、(20.33±1.87)mm^(2)];管腔直径[(6.47±0.48)mm]大于对照组[(5.53±0.43)mm],P<0.05。治疗后,观察组患者的头晕、头刺痛、肢体麻木、口唇紫暗中医症候积分分别为(1.02±0.56)、(2.02±1.48)、(2.34±0.47)、(2.26±1.22)分,均低于对照组[(2.34±0.43)、(3.20±1.03)、(3.33±1.87)、(3.51±1.49)分],P<0.05。治疗后,观察组全血黏度低切、中切、高切及血浆黏度均低于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论溶栓胶囊联合阿司匹林肠溶片治疗颈动脉硬化斑块能提高临床疗效,改善斑块情况,降低中医证候积分,改善血流变指标,且无明显不良反应发生,安全性较高。展开更多
基金Supported by A Grant offered by West China Hospital, Sichuan University, No. 2007SZ018
文摘AIM: To investigate and evaluate the feasibility of the computer-aided screening diagnosis for enteric lesions in the capsule endoscopy (CE).METHODS: After developing a series of algorithms for the screening diagnosis of the enteric lesions in CE based on their characteristic colors and contours, the normal and abnormal images obtained from 289 patients were respectively scanned and diagnosed by the CE readers and by the computer-aided screening for the enteric lesions with the image-processed software (IPS). The enteric lesions shown by the images included esoenteritis, mucosal ulcer and erosion, bleeding, space-occupying lesions, angioectasia, diverticula, parasites, etc. The images for the lesions or the suspected lesions confirmed by the CE readers and the computers were collected, and the effectiveness rate of the screening and the number of the scanned images were evaluated, respectively.RESULTS: Compared with the diagnostic results obtained by the CE readers, the total effectiveness rate (sensitivity) in the screening of the commonly-encountered enteric lesions by IPS varied from 42.9% to 91.2%, with a median of 74.2%, though the specificity and the accuracy rates were still low, and theimages for the rarely-encountered lesions were difficult to differentiate from the normal images. However, the number of the images screened by IPS was 5000 on average, and only 10%-15% of the original images were left behind. As a result, a large number of normal images were excluded, and the reading time decreased from 5 h to 1 h on average.CONCLUSION: Though the total accuracy and specificity rates by the computer-aided screening for the enteric lesions with IPS are much lower than those by the CE readers, the computer-aided screening diagnosis can exclude a large number of the normal images and confine the enteric lesions to 5000 images on average, which can reduce the workload of the readers in the scanning of the images. This computer-aided screening technique can make a correct diagnosis as efficiently as possible in most of the patients.
文摘Colon capsule endoscopy (CCE) was first put into clinical practice for the evaluation of the small bowel in patients presenting with a gastrointestinal bleed unsuccessfully diagnosed by upper GI endoscopy and colonoscopy. With the recent advent of new technology, there is improved visualization of the intestinal mucosa and subsequently a higher sensitivity for identification of mural pathology, as seen in many recent prospective studies. CCE has now been studied both in the US and in Europe as a modality for colon cancer screening as well as for the diagnosis of inflammatory bowel disease. When compared to conventional colonoscopy, CCE has been shown to have a sensitivity of greater than 88% for identifying 6mm colonic polyps and over 90% for 1 cm polyps. Therefore its use as a screening tool for colon cancer must be evaluated. In patients suspected to have colitis secondary to inflammatory bowel disease (IBD), it has been shown to have 89% sensitivity for identifying active colonic inflammation. For higher risk patients that requiring urgent colonoscopy, CCE offers an attractive alternative with the potential for a reduced risk on iatrogenic injury. Colon capsule endoscopy may also play an important role in the diagnosis and surveillance of IBD with colonic manifestations. Colonoscopy during active severe disease is associated with an increased risk of perforation due to mucosal inflammation and friability, allowing us to consider CCE as a potentially safer alternative. CCE appears to be most useful for patients with acute lower GI bleeding, inflammatory bowel disease, colonic ischemia or other mucosal-based lesions.
文摘脉血康胶囊(肠溶片)治疗心脑血管疾病具有良好的临床疗效及安全性。在临床医生问卷调查和脉血康胶囊(肠溶片)研究文献系统回顾的基础上,采用国际临床医学专家共识研制方法,基于现有最佳证据,充分结合专家经验,遵循“循证为主,共识为辅,经验为鉴”的原则,国内26位中西医临床、药学、方法学等多学科专家共同研制该共识,旨在进一步提高临床医生对该药的认识,更好地指导其临床合理用药。共识采用国际公认的证据分级推荐标准即评估、发展和评价建议的分级(Grading of Recommendations Assessment,Development and Evaluation,GRADE分级),如果证据充分则形成“推荐意见”,采用GRADE网格计票规则;如果证据不充分,则形成“共识建议”,采用多数计票规则。共识对脉血康胶囊(肠溶片)用于心脑血管疾病的适应证、用法用量、疗程、禁忌证、合并用药进行了推荐或建议,并完善了安全性信息,为其临床的合理使用提供参考。
文摘目的建立虎地肠溶胶囊多成分定量方法,并结合化学计量学方法对其进行质量评价。方法采用超高效液相色谱—四极杆静电场轨道阱高分辨质谱法(ultra-performance liquid chromatography-quadrupole-electrostatic field Orbitrap high-resolution mass spectrometry,UPLC-Orbitrap-HRMS)测定10批虎地肠溶胶囊中没食子酸、虎杖苷、甘草酸、白藜芦醇、鞣花酸、甘草素、甘草苷、大黄素、绿原酸、异甘草素、咖啡酸、木犀草素、芒柄花素、芹菜素、槲皮素和山柰酚的含量,并采用聚类分析、主成分分析、正交偏最小二乘法判别分析和灰色关联度分析对样品进行综合评价。结果16个成分线性关系良好,专属性、精密度、重复性、稳定性和平均加样回收率实验均符合标准。10批虎地肠溶胶囊被分为2类,甘草素、木犀草素、白藜芦醇、鞣花酸、槲皮素、山柰酚、咖啡酸、绿原酸和大黄素9个成分对样品质量的差异影响较大;以质量优劣情况对样品进行排序,第Ⅰ类样品的质量普遍劣于第Ⅱ类,木犀草素、鞣花酸、槲皮素、山柰酚、绿原酸和大黄素6个成分的含量偏低可能是第Ⅰ类样品质量低劣的原因。结论建立的虎地肠溶胶囊多成分定量方法结合化学计量学分析可用于该药物的质量评价。
文摘目的探讨溶栓胶囊联合阿司匹林治疗颈动脉硬化斑块的疗效。方法选取100例颈动脉粥样硬化斑块患者作为研究对象,用随机数字表法分为观察组(55例,用溶栓胶囊联合阿司匹林肠溶片治疗)和对照组(45例,用阿司匹林肠溶片治疗)。观察2组治疗后的临床疗效、斑块情况、中医症状积分、血流变指标和不良反应发生情况。结果治疗后,观察组的临床总有效率(96.36%)高于对照组(80.00%),P<0.05。观察组患者的内-中膜的厚度(intima media thickness,IMT)和斑块面积分别为(0.95±0.16)mm、(19.34±1.47)mm^(2),均低于对照组[(1.24±0.18)mm、(20.33±1.87)mm^(2)];管腔直径[(6.47±0.48)mm]大于对照组[(5.53±0.43)mm],P<0.05。治疗后,观察组患者的头晕、头刺痛、肢体麻木、口唇紫暗中医症候积分分别为(1.02±0.56)、(2.02±1.48)、(2.34±0.47)、(2.26±1.22)分,均低于对照组[(2.34±0.43)、(3.20±1.03)、(3.33±1.87)、(3.51±1.49)分],P<0.05。治疗后,观察组全血黏度低切、中切、高切及血浆黏度均低于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论溶栓胶囊联合阿司匹林肠溶片治疗颈动脉硬化斑块能提高临床疗效,改善斑块情况,降低中医证候积分,改善血流变指标,且无明显不良反应发生,安全性较高。
