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Microecology-turbidity toxin theory: correlation between helicobacter pylori infection and manifestation of tongue and Gastroscopy

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Journal of Traditional Chinese Medicine 2022年第3期42卷 458-462页

作者： WANG Jin WANG Huijie XIAO Ying GUO Jiaxuan ZHAO Yubin Department of Integrated Chinese and Western Medicine Hebei University of Chinese MedicineShijiazhuang 050000China the Traditional Chinese Medicine Hospital of Shijiazhuang Affiliated to Hebei University of Chinese Medicine Shijiazhuang 050000China Department of Bioengineering School of Chemical EngineeringShijiazhuang UniversityShijiazhuang 050000China The Traditional Chinese Medicine Hospital of Shijiazhuang Affiliated to Hebei University of Chinese Medicine Shijiazhuang 050000HebeiChina Shijiazhuang People's Hospital Shijiazhuang 050000China

OBJECTIVE:To clarify the relationship between helicobacter pylori(Hp)infection,tongue manifestation and gastroscopic manifestation,and explore the mechanism of action of“oral-gastric microecology”in the occurrence and development of stomach-related diseases.MEDHODS:A total of 1100 patients were divided into Hp positive group and Hp negative group according to 13 C breath test results.The tongue manifestation materials from patients were collected to make tongue printing slides for morphological observation of exfoliative cells from tongue coating,and electronic Gastroscopy was performed on the patients and the data was analyzed.RESULTS:Hp infection rate was about 45.95%;and the greasy coating was mostly observed in Hp positive group(63.14%,Pyellow coating>white coating>white greasy coating.The gastric mucosal roughness and mucosal hematoplastic plaques in the two groups were more common in the Hp positive group(P<0.05).There was a significant difference in the granular subgroup and in the rough mucosal group(P<0.05).CONCLUSIONS:Hp infection is more commonly observed in yellow greasy coating,and this can be used as a reference for Traditional Chinese Medicine in determining whether it is Hp infection or not.Mucosal granule roughness,hyperemia,and oral Hp showed association with Hp infection in the stomach and interacted with micro-ecological environment that is composed of the oral cavity.

关键词： Helicobacter pylori abnormal tongue presentations Gastroscopy breath tests micro-ecology turbidity toxin theory

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Combination of propofol and dezocine to improve safety and efficacy of anesthesia for Gastroscopy and colonoscopy in adults: A randomized, double-blind, controlled trial

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World Journal of Clinical Cases 2019年第20期7卷 3237-3246页

作者： Xue-Ting Li Chao-Qun Ma Si-Hua Qi Li-Min Zhang Department of Anaesthesiology The Fourth Affiliated HospitalHarbin Medical UniversityHarbin 150001Heilongjiang ProvinceChina Department of Neurosurgery Harbin 242 HospitalHarbin 150066Heilongjiang ProvinceChina

BACKGROUND Gastroscopy and colonoscopy are important and common endoscopic methods for the diagnosis and treatment of gastrointestinal and colorectal diseases.However,endoscopy is usually associated with adverse reactions such as nervousness,nausea,vomiting,choking cough,and pain.Severe discomfort,such as vomiting,coughing,or body movement,may lead to aggravation of a preexisting condition or even interruption of examination or treatment,especially in some critically ill patients with physiological dysfunction(e.g.,cardiovascular or respiratory disease).The optimal methods for inducing analgesia and sedation in endoscopy are areas of ongoing debate;nevertheless,determining an appropriate regimen of sedation and analgesia is important.AIM To evaluate the effects of propofol combined with dezocine,sufentanil,or fentanyl in painless Gastroscopy and colonoscopy.METHODS Four hundred patients were randomly assigned to one of four groups for anesthesia:intravenous dezocine,sufentanil,fentanyl,or saline.Propofol was administered intravenously for induction and maintenance of anesthesia.RESULTS The dosage of propofol in the dezocine group was significantly lower than those in other groups(P<0.01).Bispectral index and Steward score(0-6 points,an unresponsive,immobile patient whose airway requires maintenance to a fully recovered patient)after eye opening in the dezocine group were significantly higher than those in other groups(P<0.01).Awakening time and postoperative pain score(0-10 points,no pain to unbearable pain)in the dezocine group were significantly lower than those in other groups(P<0.01).Mean arterial pressure and pulse oxygen saturation in the dezocine group were significantly more stable at various time points(before dosing,disappearance of eyelash reflex,and wakeup)than those in other groups(P<0.01).The rates of hypopnea,jaw thrust,body movements,and usage of vasoactive drugs in the dezocine group were significantly lower than those in other groups(P<0.01).Additionally,the rates of reflex coughing,nausea,and v

关键词： Anesthesia Dezocine Propofol Gastroscopy Colonoscopy

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Clinical application of magnetically controlled capsule Gastroscopy in gastric disease diagnosis: recent advances

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Science China(Life Sciences) 2018年第11期61卷 1304-1309页

作者： Zhuan Liao Wenbin Zou Zhao-Shen Li Department of Gastroenterology Changhai Hospital the Second Military Medical University

Magnetically controlled capsule Gastroscopy(MCCG) is a novel system primarily used for the diagnosis of gastric disease. It consists of an endoscopic capsule with magnetic material inside, external guidance magnet equipment, data recorder and computer workstation. Several clinical trials have demonstrated that MCCG is comparable in accuracy in diagnosing gastric focal disease when compared to conventional Gastroscopy. Further clinical studies are needed to test the diagnostic accuracy and improve the functioning of MCCG. This novel MCCG system could be a promising alternative for screening for gastric diseases,with the advantages of no anesthesia required, comfort and high acceptance across populations.

关键词： magnetically controlled capsule endoscopy gastric diseases screening conventional Gastroscopy diagnostic accuracy

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Impact of a simulation-based induction programme in Gastroscopy on trainee outcomes and learning curves

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World Journal of Gastrointestinal Endoscopy 2020年第3期12卷 98-110页

作者： Keith Siau James Hodson Peter Neville Jeff Turner Amanda Beale Susi Green Aravinth Murugananthan Paul Dunckley Neil D Hawkes Joint Advisory Group on Gastrointestinal Endoscopy Royal College of PhysiciansLondon NW14LEUnited Kingdom Medical and Dental Sciences University of BirminghamBirmingham B152TTUnited Kingdom Institute of Translational Medicine University Hospitals BirminghamBirmingham B152THUnited Kingdom Department of Gastroenterology Cwm Taf Morgannwg Health BoardLlantrisant CF454SNUnited Kingdom Department of Gastroenterology Cardiff and Vale University Health BoardCardiff CF144XWUnited Kingdom Department of Gastroenterology University Hospitals Bristol NHSFTBristol BS13NUUnited Kingdom Department of Gastroenterology Royal Sussex County HospitalBrighton BN25BEUnited Kingdom Department of Gastroenterology Royal Wolverhampton NHS TrustWolverhampton W100QPUnited Kingdom Department of Gastroenterology Gloucestershire Hospitals NHSFTGloucester GL13NNUnited Kingdom

BACKGROUND Pre-clinical simulation-based training(SBT)in endoscopy has been shown to augment trainee performance in the short-term,but longer-term data are lacking.AIM To assess the impact of a two-day Gastroscopy induction course combining theory and SBT(Structured PRogramme of INduction and Training–SPRINT)on trainee outcomes over a 16-mo period.METHODS This prospective case-control study compared outcomes between novice SPRINT attendees and controls matched from a United Kingdom training database.Study outcomes comprised:(1)Unassisted D2 intubation rates;(2)Procedural discomfort scores;(3)Sedation practice;(4)Time to 200 procedures;and(5)Time to certification.RESULTS Total 15 cases and 24 controls were included,with mean procedure counts of 10 and 3(P=0.739)pre-SPRINT.Post-SPRINT,no significant differences between the groups were detected in long-term D2 intubation rates(P=0.332)or discomfort scores(P=0.090).However,the cases had a significantly higher rate of unsedated procedures than controls post-SPRINT(58%vs 44%,P=0.018),which was maintained over the subsequent 200 procedures.Cases tended to perform procedures at a greater frequency than controls in the post-SPRINT period(median:16.2 vs 13.8 per mo,P=0.051),resulting in a significantly greater proportion of cases achieving Gastroscopy certification by the end of follow up(75% vs 36%,P=0.017).CONCLUSION In this pilot study,attendees of the SPRINT cohort tended to perform more procedures and achieved Gastroscopy certification earlier than controls.These data support the role for wider evaluation of pre-clinical induction involving SBT.

关键词： Gastroscopy Esophagogastroduodenoscopy Endoscopy training Induction Competency development Simulation

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Long-term clinical outcomes of lipiodol marking using standard Gastroscopy for image-guided radiotherapy of upper gastrointestinal cancers

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World Journal of Gastroenterology 2021年第42期27卷 7387-7401页

作者： Kim Hay Be Richard Khor Daryl Lim Joon Ben Starvaggi Michael Chao Sweet Ping Ng Michael Ng Leonardo Zorron Cheng Tao Pu Marios Efthymiou Rhys Vaughan Sujievvan Chandran Department of Gastroenterology and Hepatology Austin HealthHeidelberg 3084VictoriaAustralia Department of Radiation Oncology Austin HealthHeidelberg 3084VictoriaAustralia School of Cancer Medicine La Trobe UniversityMelbourne 3086VictoriaAustralia Medicine Dentistry and Health SciencesUniversity of MelbourneParkville 3010VictoriaAustralia Genesis Care East Melbourne 3002VictoriaAustralia

BACKGROUND Image-guided radiotherapy(IGRT)has significantly improved the precision in which radiotherapy is delivered in cancer treatment.Typically,IGRT uses bony landmarks and key anatomical structures to locate the tumor.Recent studies have demonstrated the feasibility of peri-tumor fiducials in enabling even more accurate delineation of target and normal tissue.The use of gold coils as fiducials in gastrointestinal tumors has been extensively studied.However,placement requires expertise and specialized endoscopic ultrasound equipment.This article reports the long-term outcomes of using a standard Gastroscopy to inject liquid fiducials for the treatment of oesophageal and gastric tumors with IGRT.AIM To assess the long-term outcomes of liquid fiducial-guided IGRT in a cohort of oesophageal and gastric cancer patients.METHODS A retrospective cohort study of consecutive adults with Oesophagogastric cancers referred for liquid fiducial placement before definitive/neo-adjuvant or palliative IGRT between 2013 and 2021 at a tertiary hospital in Melbourne,Australia was conducted.Up to four liquid fiducials were inserted per patient,each injection consisting of 0.2-0.5mL of a 1:1 mixture of iodized oil(Lipiodol;Aspen Pharmacare)and n-butyl 2-cyanoacrylate(Histoacryl®;B.Braun).A 23-gauge injector(Cook Medical)was used for the injection.All procedures were performed by or under the supervision of a gastroenterologist.Liquid fiducial-based IGRT(LF-IGRT)consisted of computer-assisted direct matching of the fiducial region on cone-beam computerised tomography at the time of radiotherapy.Patients received standard-IGRT(S-IGRT)if fiducial visibility was insufficient,consisting of bone match as a surrogate for tumor position.Radiotherapy was delivered to 54Gy in 30 fractions for curative patients and up to 45Gy in 15 fractions for palliative treatments.RESULTS 52 patients were referred for liquid fiducial placement within the study period.A total of 51 patients underwent liquid fiducial implantation.Of these a total of 31 pati

关键词： Image-guided radiotherapy Lipiodol Gastroscopy Gastric cancer Oesophageal cancer Fiducial

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Prospective, randomized comparison of two supplemental oxygen methods during gastro-scopy with propofol mono-sedation in obese patients

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World Journal of Clinical Cases 2021年第20期9卷 5479-5489页

作者： Liu-Jia-Zi Shao Fang-Xiao Hong Fu-Kun Liu Lei Wan Fu-Shan Xue Department of Anesthesiology Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China

BACKGROUND Hypoxemia is a common complication in obese patients during Gastroscopy with sedation.The Wei nasal jet tube(WNJT)is a new special nasopharyngeal airway with the ability to provide supraglottic jet ventilation and oxygen insufflation via its built-in wall channels.The aim of this study was to compare the efficacy and safety of the WNJT vs a nasal cannula for supplemental oxygen during Gastroscopy with propofol mono-sedation in obese patients.AIM To compare the efficacy and safety of the WNJT vs a nasal cannula for supplemental oxygen during Gastroscopy with propofol mono-sedation in obese patients.METHODS A total of 103 obese patients with a body mass index of 30 kg/m2 or more undergoing elective Gastroscopy under propofol mono-sedation were randomly assigned to receive supplemental oxygen at 5 L/min through either a WNJT(WNJT group,n=51)or a nasal cannula(nasal cannula group,n=52).The lowest pulse oxygen saturation(SpO2)and mild and severe hypoxemia during Gastroscopy were recorded.The primary outcome was the incidence of hypoxemia.RESULTS The lowest SpO2 during Gastroscopy with propofol mono-sedation was significantly increased in the WNJT group compared with the nasal cannula group.The incidence of mild hypoxemia and total incidence of hypoxemia were significantly lower in the WNJT group than in the nasal cannula group.Other than a higher incidence of epistaxis in the WNJT group,the occurrence of adverse events was similar between the devices.While neither device demonstrated a statistically significant difference in satisfaction among patients,the WNJT did result in improved satisfaction among anesthetists and physicians.CONCLUSION During Gastroscopy with propofol mono-sedation in obese patients,the WNJT,when compared with a nasal cannula for supplemental oxygen,can significantly reduce the occurrence of hypoxemia and improve both arterial oxygenation and satisfaction among anesthetists and physicians.The use of the WNJT may,however,lead to epistaxis in a few patients.In view of this clinically acc

关键词： Supplemental oxygen Gastroscopy Sedation Obese patients

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Efficacy of small-volume simethicone given at least 30 min before Gastroscopy

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2016年第4期7卷 572-578页

作者： Mingjun Song Andrew Boon Eu Kwek Ngai Moh Law Jeannie Peng Lan Ong Jessica Yi-Lyn Tan Prem Harichander Thurairajah Daphne Shih Wen Ang Tiing Leong Ang Department of Gastroenterology and Hepatology Changi General Hospital

AIM To evaluate the efficacy of 5 m L simethicone solution in decreasing gastric foam if given at least 30 min before Gastroscopy.METHODS This was a randomized, placebo controlled, endoscopist blinded study performed at Changi General Hospital. Patients were at least 21 years old, had no prior sur-gical resection of the upper gastrointestinal tract, and scheduled for elective diagnostic gastroscopies. The primary outcome was the total mucosal visibility score(TMVS) which was evaluated using Mc Nally score. The sample size was calculated to be 24 per group(SD 2.4, 80% power, P Gastroscopy. Six accredited consultants conductedthe Gastroscopy, and the interobserver agreement of scoring TMVS was good with a Kappa statistic of 0.73. The simethicone group had significantly better mean TMVS compared to placebo(5.78 ± SD 1.65 vs 8.89 ± SD 1.97, P Gastroscopy to clear away obscuring gastric foam.CONCLUSION With a premedication time of at least 30 min, 5 m L simethicone can significantly decrease gastric foam, decrease the volume of additional flushes, and shorten Gastroscopy time.

关键词： Simethicone Premedication Gastroscopy 胃的泡沫

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Clinical applicability of Gastroscopy with narrow-band imaging for the diagnosis of Helicobacter pylori gastritis, precancerous gastric lesion, and neoplasia

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World Journal of Clinical Cases 2020年第14期8卷 2902-2916页

作者： Jun-Hyung Cho Seong Ran Jeon So-Young Jin Digestive Disease Center Soonchunhyang University HospitalSeoul 04401South Korea Department of Pathology Soonchunhyang University HospitalSeoul 04401South Korea

Premalignant gastric lesions such as atrophic gastritis and intestinal metaplasia frequently occur in subjects with long-term Helicobacter pylori(H.pylori)infection.The regular arrangement of collecting venules(RAC)is seen in the normal gastric corpus,whereas mucosal swelling and redness without RAC are observed in H.pylori-infected mucosa.Despite successful H.pylori eradication,the presence of atrophic gastritis and/or gastric intestinal metaplasia(GIM)is a risk factor for gastric cancer.With the development of advanced imaging technologies,recent studies have reported the usefulness of narrow-band imaging(NBI)for endoscopic diagnosis of atrophic gastritis and GIM.Using NBI endoscopy with magnification(M-NBI),atrophic gastritis is presented as irregular coiled microvessels and loss of gastric pits.Typical M-NBI endoscopic findings of GIM are a light blue crest and a white opaque substance.Based on the microvascular patterns,fine network,core vascular,and unclear patterns are useful for predicting gastric dysplasia in polypoid lesions.For diagnosis of early gastric cancer(EGC),a systematic classification using M-NBI endoscopy has been proposed on the basis of the presence of a demarcation line and an irregular microvascular/microsurface pattern.Furthermore,M-NBI endoscopy has been found to be more accurate for determining the horizontal margin of EGC compared to conventional endoscopy.In this review,we present up-to-date results on the clinical usefulness of Gastroscopy with NBI for the diagnosis of H.pylori gastritis,precancerous gastric lesion,and neoplasia.

关键词： Gastroscopy Narrow-band imaging Magnification Helicobacter pylori Atrophic gastritis Intestinal metaplasia Dysplasia Cancer

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Comparison of two supplemental oxygen methods during Gastroscopy with propofol mono-sedation in patients with a normal body mass index

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World Journal of Gastroenterology 2020年第43期26卷 6867-6879页

作者： Liu-Jia-Zi Shao Yi Zou Fu-Kun Liu Lei Wan Shao-Hua Liu Fang-Xiao Hong Fu-Shan Xue Department of Anesthesiology Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China

BACKGROUND Hypoxemia due to respiratory depression and airway obstruction during upper gastrointestinal endoscopy with sedation is a common concern.The Wei nasal jet tube(WNJT)is a new nasopharyngeal airway with the ability to provide supraglottic jet ventilation and oxygen insufflation via its built-in wall channel.The available evidence indicates that with a low oxygen flow,compared with nasal cannula,the WNJT does not decrease the occurrence of hypoxemia during upper gastrointestinal endoscopy with propofol sedation.To date,there has been no study assessing the performance of WNJT for supplemental oxygen during upper gastrointestinal endoscopy with sedation when a moderate oxygen flow is used.AIM To determine whether the WNJT performs better than the nasal prongs for the prevention of hypoxemia during Gastroscopy with propofol mono-sedation when a moderate oxygen flow is provided in patients with a normal body mass index.METHODS This study was performed in 291 patients undergoing elective Gastroscopy with propofol mono-sedation.Patients were randomized into one of two groups to receive either the WNJT(WNJT group,n=147)or the nasal cannula(nasal cannula group,n=144)for supplemental oxygen at a 5-L/min flow during Gastroscopy.The lowest SpO2 during Gastroscopy was recorded.The primary endpoint was the incidence of hypoxemia or severe hypoxemia during Gastroscopy.RESULTS The total incidence of hypoxemia and severe hypoxemia during Gastroscopy was significantly decreased in the WNJT group compared with the nasal cannula group(P=0.000).The lowest median SpO2 during Gastroscopy was significantly higher(98%;interquartile range,97-99)in the WNJT group than in the nasal cannula group(96%;interquartile range,93-98).Epistaxis by device insertion in the WNJT group occurred in 7 patients but stopped naturally without any treatment.The two groups were comparable in terms of the satisfaction of physicians,anesthetists and patients.CONCLUSION With a moderate oxygen flow,the WNJT is more effective for the prevention of hypoxem

关键词： Gastroscopy Hypoxemia Wei nasal jet tube Nasal cannula Supplemental oxygen Adverse outcomes

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Study of wrist-ankle acupuncture therapy for optimizing anaesthesia scheme of painless Gastroscopy and improving painless Gastroscopy related complications

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World Journal of Gastrointestinal Endoscopy 2023年第2期15卷 56-63页

作者： Li-Yan Zheng Sui-Cai Mi Ling-Yan Wu Zheng-Jin Xu Hao Lu Department of Anesthesiology Xiamen Hospital of Traditional Chinese MedicineXiamen 361000Fujian ProvinceChina Department of Oncology Xiamen Hospital of Traditional Chinese MedicineXiamen 361000Fujian ProvinceChina Department of Nephropathy Xiamen Hospital of Traditional Chinese MedicineXiamen 361000Fujian ProvinceChina Department of Nephrology Xiamen Hospital of Traditional Chinese MedicineXiamen 361000Fujian ProvinceChina Department of Hepatobiliary and Pancreatic Surgery Xiamen Hospital of Traditional Chinese MedicineXiamen 361000Fujian ProvinceChina

BACKGROUND Painless Gastroscopy is a widely used diagnostic and therapeutic technology in clinical practice.Propofol combined with opioids is a common drug for painless endoscopic sedation and anaesthesia.In clinical work,adverse drug reactions of anaesthesia schemes are often one of the important areas of concern for doctors and patients.With the increase in propofol dosage,the risk of serious adverse drug reactions,such as respiratory depression and hypotension,increases significantly;the use of opioids often causes gastrointestinal reactions in patients after examination,such as nausea,vomiting,delayed recovery of gastrointestinal function and other complications,which seriously affect their quality of life.AIM To observe the effect of wrist-ankle acupuncture therapy on the anaesthesia regimen and anaesthesia-related complications during and after painless Gastroscopy examination.METHODS Two hundred patients were selected and randomly divided into a treatment group(n=100)and a control group(n=100).Both groups were routinely anaesthetized with the nalbuphine and propofol regimen,Gastroscopy began after the patient lost consciousness,and given supportive treatment and vital sign monitoring.If the patient interrupted the surgery due to intraoperative torsion,intravenous propofol was used to relieve his or her discomfort.The treatment group received wrist-ankle acupuncture on this basis.RESULTS The general data before treatment,American Society of Anesthesiologist(ASA)grade and operation time between the two groups was no significant difference.The Wakeup time,and the Selfambulation time in the treatment group was significantly faster than that in the control group(P<0.05).The total dose of propofol in the treatment group was 109±8.17 mg,significantly lower than that in the control group(P<0.05).The incidence of respiratory depression and hypotension was not significantly different,but the incidence of hiccups was significantly lower than that in the control group(P<0.05).After the examination,the incidence of nau

关键词： Wrist-ankle acupuncture therapy Acupuncture anaesthesia Painless Gastroscopy Gastroscopy Anaesthesia-related complications

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