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Effects of premedication with pronase for endoscopic ultrasound of the stomach: A randomized controlled trial

World Journal of Gastroenterology 2016年第48期22卷 10673-10679页

作者： Guo-Xin Wang Xiang Liu Sheng Wang Nan Ge Jin-Tao Guo Si-Yu Sun Endoscopy Center Shengjing Hospital of China Medical University

AIM To analyze the effects of premedication with pronase for endoscopic ultrasound(EUS) examination of the stomach.METHODS This was a prospective, randomized and controlled clinical study. All patients were randomly assigned to either the pronase group or placebo group. The pretreatment solution was a mixed solution of 20000 U of pronase and 60 m L sodium bicarbonate solution in the pronase group, while an equal amount of sodium bicarbonate solution was administered to the placebo group. All operators, image evaluators and experimental recorders in EUS did not participate in the preparation and allocation of pretreatment solution. Two blinded investigators assessed the obscurity scores for the EUS images according to the size of artifacts(including ultrasound images of the gastric cavity and the gastric wall). Differences in imaging quality, the duration of examination and the usage of physiological saline during the examination process between the pronase group and the control group were compared.RESULTS No differences existed in patient demographics between the two groups. For the gastric cavity, the pronase group had significantly lower mean obscurity scores than the placebo group(1.0476 ± 0.77 vs 1.6129 ± 0.96, respectively, P = 0.000). The mean obscurity scores for the gastric mucosal surface were significantly lower in the pronase group than the placebo group(1.2063 ± 0.90 vs 1.7581 ± 0.84, respectively, P = 0.001). The average EUS procedure duration for the pronase group was 11.60 ± 3.32 min, which was significantly shorter than that of the placebo group(13.13 ± 3.81 min, P = 0.007). Less saline was used in the pronase group than the placebo group, and the difference was significant(417.94 ± 121.38 m L vs 467.42 ± 104.52 mL, respectively, P = 0.016).CONCLUSION The group that had pronase premedication prior to the EUS examination had clearer images than the placebo group. With pronase premedication, the examination time was shorter, and the amount of saline used during the EUS examination was less.

关键词： Artifacts Randomized controlled trial Endosonography pronase Stomach

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Effect of pronase as mucolytic agent on imaging quality of magnifying endoscopy

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World Journal of Gastroenterology 2015年第8期21卷 2483-2489页

作者： Gwang Ha Kim Yu Kyung Cho Jae Myung Cha Sun-Young Lee Il-Kwun Chung Department of Internal Medicine Pusan National University School of Medicine Department of Internal Medicine The Catholic University of Korea Department of Internal Medicine Kyung Hee University Hospital at Gang Dong Department of Internal Medicine Konkuk University Medical Center Department of Internal Medicine Soonchunhyang University

AIM:To investigate the efficacy of premedication with pronase,a proteolytic enzyme,in improving imagequality during magnifying endoscopy.METHODS:The study was of a blinded,randomized,prospective design.Patients were assigned to groups administered oral premedication of either pronase and simethicone(Group A)or simethicone alone(Group B).First,the gastric mucosal visibility grade(1-4)was determined during conventional endoscopy,and then a magnifying endoscopic examination was conducted.The quality of images obtained by magnifying endoscopy at the stomach and the esophagus was scored from1 to 3,with a lower score indicating better visibility.The endoscopist used water flushes as needed to obtain satisfactory magnifying endoscopic views.The main study outcomes were the visibility scores during magnifying endoscopy and the number of water flushes.RESULTS:A total of 144 patients were enrolled,and data from 143 patients(M:F=90:53,mean age 57.5 years)were analyzed.The visibility score was significantly higher in the stomach following premedication with pronase(73%with a score of 1 in Group A vs 49%in Group B,Ppronase premedication group did not affect the endoscopic procedure times[mean 766 s(range:647-866 s)for Group A vs 760 s(range:678-854 s)for Group B,P=0.88].The total gastric mucosal visibility score was also lower in Group A(4.9±1.5 vs 8.3±1.8in Group B,Ppronase to simethicone premedication resulted in clearer images during magnifying endoscopy and reduced the need for water flushes.

关键词： pronase Narrow-band imaging,EndoscopyImage enhance

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Efforts to increase image quality during endoscopy:The role of pronase

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World Journal of Gastrointestinal Endoscopy 2016年第5期8卷 267-272页

作者： Gwang Ha Kim Yu Kyung Cho Jae Myung Cha Sun-Young Lee Il-Kwun Chung Department of Internal Medicine Pusan National University School of Medicine and Biomedical Research InstitutePusan National University Hospital Department of Internal Medicine the Catholic University of KoreaCollege of Medicine Department of Internal Medicine Kyung Hee University Hospital at Gang DongKyung Hee University School of Medicine Department of Internal Medicine Konkuk University School of Medicine Department of Internal Medicine Soonchunhyang University Cheonan HospitalSoonchunhyang University College of Medicine

Clear visualization of the gastrointestinal mucosal surface is essential for thorough endoscopy. An unobstructed assessment can reduce the need for additional timeconsuming manipulations such as frequent washing and suction,which tend to prolong total procedure time. However,mucus,foam,and bubbles often hinder clear visibility during endoscopy. Premedication with pronase,a compound of mixed proteolytic enzymes,has been studied in order to improve mucosal visibility during endoscopy. Although its effects differ according to the location in the stomach,premedication with pronase 10 to 20 min before endoscopy significantly improves mucosal visibility without affecting the accuracy of Helicobacter pylori identification. The effects of pronase as premedication also extend to chromoendoscopy,narrow-band imaging,magnifying endoscopy,and endoscopic ultrasonography. In addition,endoscopic flushing with pronase during endoscopy may improve the quantity and the quality of a biopsy to some degree. Although improved mucosal visibility does not necessarily improve clinical outcomes,premedication with pronase may be helpful for increasing the detection rate of early cancers.

关键词： Endoscopy Premedication pronase

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蛋白酶pronase处理动物毒蛇蛇伤的研究

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科学通报 1975年第6期20卷 292-293页

作者：熊郁良邹如金侯意帝刘次全周瑆良李靖炎云南省动物研究所

蛇毒中的主要毒性成分是毒蛋白。在给动物注射蛇毒后,朝注射部位注射蛋白酶类,可以把蛇毒的毒性蛋白质水解,以达到治疗蛇伤的目的。我们过去的工作证明,以胰蛋白酶治疗动物蛇伤具有显著疗效。无疑,胰蛋白酶决不是唯一可以用来治疗蛇伤... 详细信息

蛇毒中的主要毒性成分是毒蛋白。在给动物注射蛇毒后,朝注射部位注射蛋白酶类,可以把蛇毒的毒性蛋白质水解,以达到治疗蛇伤的目的。我们过去的工作证明,以胰蛋白酶治疗动物蛇伤具有显著疗效。无疑,胰蛋白酶决不是唯一可以用来治疗蛇伤的蛋白酶,为此,我们对其他一些蛋白酶的治疗效果也作了检验。本文报道以蛋白酶pronase处理动物毒蛇蛇伤的实验结果。

关键词：蛋白酶类 pronase 小白鼠蛇毒毒液蛇伤毒蛇动物

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基于质谱的糖蛋白糖链结构解析策略研究

基于质谱的糖蛋白糖链结构解析策略研究

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作者：张曼丽安徽医科大学

学位级别：硕士

蛋白质糖基化修饰在生理病理过程中起着重要作用,但糖蛋白质糖链结构分析方法仍在发展中,糖蛋白质组学的方法研究成为研究重点。在病理发生发展过程中,位点特异性糖链结构的变化显著。而传统的PNGase F切糖与相应的修饰位点与糖链结构... 详细信息

蛋白质糖基化修饰在生理病理过程中起着重要作用,但糖蛋白质糖链结构分析方法仍在发展中,糖蛋白质组学的方法研究成为研究重点。在病理发生发展过程中,位点特异性糖链结构的变化显著。而传统的PNGase F切糖与相应的修饰位点与糖链结构鉴定技术,无法将糖肽的糖基化位点,与相应的糖链联系在一起,所以,位点特异性糖链结构解析成为当前糖蛋白质组研究的重要目标。本论文有三章构成,第一章,首先介绍糖蛋白质组学的研究现状,糖基化位点及糖链结构解析的重要性;其次对糖基化位点、糖链结构获取方法及完整糖肽结构解析的常用策略进行概述。第二章,介绍了基于固定化pronase E酶切,解析位点特异糖链结构方法的建立。文中对pronase E溶液酶切的蛋白与酶的用量比,酶切时间,pronase E固定化酶的材料选择,及固定化酶的有效贮存时间进行监测,并比较优化了亲水相互作用色谱和多孔石墨化炭黑两种富集方法、α-氰基-4-羟基肉桂酸和2,5-二羟基苯甲酸两种基质,对于糖链结构鉴定的选择性。另外,对比了MALDI-TOF仪器和高精度Q-Exactive仪器,对于检测糖链结构或完整糖蛋白方面的差异性。最后选择pronase E溶液酶切,蛋白比酶1:1以上,酶切时间为48 h;pronase E固定化酶的材料选用CNBr Beads,酶与材料质量比1:10的比例,进行固定化酶的合成,结合效率为40%,酶切时间为24 h。选择多孔石墨化炭黑富集,pronase E所得糖链使用DHB为基质,PNGase F所得糖链选用DHB+1 mM Na Cl为基质进行MALDI-TOF检测。第三章,建立完整糖肽的分析策略,实现对血清高丰度糖蛋白的完整糖肽的定性定量分析。以IgG为标准糖蛋白,经过Trypsin酶切及HILIC富集,获得完整糖肽,在此基础上,经过PNGase F酶切,获得糖基化位点信息,结合完整糖肽的检测信息,借助Byonic(Proteomics Discover 2.0)和Maxquant两个软件,并将两个软件得到的数据整合,获取完整糖肽的糖基化位点及糖型信息,通过位点特异性糖肽的峰面积,以实现完整糖肽定量分析。并将此方法应用于人血清11种高丰度糖蛋白的完整糖肽的分析,实现对肺癌血清样本的完整糖肽的定性定量鉴定。为获取肺癌的高丰度蛋白质糖肽组成特征,寻求可能的诊断标志物提供了方法策略。

关键词：糖蛋白糖链结构固定化 pronase E 人血清高丰度糖蛋白完整糖肽定性定量分析

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