This article comments on the article by Du et al,who conducted a randomized controlled trial aiming at evaluating the effectiveness of a novel spray flushing system in cleaning flexible endoscopes while minimizing dam...This article comments on the article by Du et al,who conducted a randomized controlled trial aiming at evaluating the effectiveness of a novel spray flushing system in cleaning flexible endoscopes while minimizing damage to the working channels.We share our perspective on the importance of improving endoscope reprocessing methods.The findings highlight the spray flushing system's capacity to improve cleaning efficacy while minimizing damage,suggesting that it might be important in enhancing endoscope reprocessing procedures.展开更多
Digestive endoscopy has been widely used in the diagnosis and treatment of digestive diseases.However,the anatomical complexity of specific lesions increases the difficulty of these operations,resulting in complicatio...Digestive endoscopy has been widely used in the diagnosis and treatment of digestive diseases.However,the anatomical complexity of specific lesions increases the difficulty of these operations,resulting in complications or treatment failure.Although various strategies,such as floss traction and the application of transparent caps,have been explored,their effectiveness remains limited due to individual differences in patients’anatomical characteristics.The multibending(MB)endoscope represents a significant innovation as it is a conventional endoscope with an additional bending section and dual channels.Currently,this technology has been applied in gastroscopy,duodenoscopy and peroral cholangioscopy.The bending part of the endoscope facilitates its passage into difficult-to-reach anatomical regions and improves operating angles,thereby enhancing surgical precision and efficiency while reducing complication rates.Furthermore,the dualchannel design accelerates procedural workflows and increases operational versatility.This innovation is poised to transform endoscopic diagnosis and treatment of digestive system diseases.Since the MB endoscope is relatively new,further research is needed to comprehensively explore its benefits for and potential in endoscopic diagnosis and treatment.The aim of this review is to summarize the current research,indications,and future directions of MB endoscope.展开更多
As the cornerstone of sterile instrument maintenance in endoscopy centers,the quality of endoscope cleaning directly impacts hospital infection control effectiveness.The traceability system for endoscopy centers utili...As the cornerstone of sterile instrument maintenance in endoscopy centers,the quality of endoscope cleaning directly impacts hospital infection control effectiveness.The traceability system for endoscopy centers utilizes digital means to document the entire cleaning process,enabling real-time monitoring and precise quality control.This paper analyzes current quality control practices in endoscope cleaning and addresses existing challenges.It explores how traceability systems standardize procedures,enhance monitoring,and improve management efficiency.The study proposes optimization strategies for traceability system implementation,clarifying its core value in endoscope cleaning quality control.These findings provide theoretical foundations and practical guidance for hospitals to refine management of endoscopy centers,ensure diagnostic safety,and reduce infection risks,ultimately advancing endoscope cleaning quality control toward standardized and informatized development.展开更多
The advancement in endoscopic technology and techniques has increased its use in the diagnosis and treatment of gastrointestinal diseases.Reprocessing of reusable endoscopes remains a challenge.Inadequate reprocessing...The advancement in endoscopic technology and techniques has increased its use in the diagnosis and treatment of gastrointestinal diseases.Reprocessing of reusable endoscopes remains a challenge.Inadequate reprocessing leads to bacterial contamination of the endoscope,a significant cause of endoscope-related infections.To thoroughly address the complexities of cleaning a flexible endo-scope,various cleaning methods have been devised and tested across different studies.This letter evaluates one such method,spray flushing for flexible gastro-scopes,developed and tested in a randomized controlled trial by Du et al.Based on the post-processing test results for this method,Du et al conclude that there is improved cleaning efficacy and reduced damage compared to manual brush cleaning.The validity and reliability of the results could be further enhanced by carefully considering the study design and a few underlying concepts that contribute to the reprocessing quality of different types of endoscopes.展开更多
BACKGROUND Current disinfection methods for gastrointestinal endoscopes consume a significant amount of water resources and produce a large volume of waste.AIM To achieve the objectives of efficiency,speed,and cost-ef...BACKGROUND Current disinfection methods for gastrointestinal endoscopes consume a significant amount of water resources and produce a large volume of waste.AIM To achieve the objectives of efficiency,speed,and cost-effectiveness,this study utilized vaporized hydrogen peroxide(VHP)generated from sodium percarbonate granules to conduct an anhydrous disinfection test on gastrointestinal endoscopes.METHODS The experimental device rapidly converts sodium percarbonate granules into VHP,and performs disinfection experiments on gastrointestinal endoscope models,disposable endoscopes,and various types of reusable gastrointestinal endoscopes.Variables such as the intraluminal flow rate(FR),relative humidity(RH),exposure dosage,and organic burden are used to explore the factors influencing the disinfection of long and narrow lumens with VHP.RESULTS The device generates a certain concentration of VHP that can achieve high-level disinfection of endoscope models within 30 minutes.RH,exposure dosage,and organic burden significantly affect the disinfection efficacy of VHP,whereas the intraluminal FR does not significantly impact disinfection efficacy.All ten artificially contaminated disposable endoscopes achieved satisfactory disinfection results.Furthermore,when this device was used to treat various types of reusable endoscopes,the disinfection and sterilization effects were not significantly different from those of automatic endoscope disinfection machines(using peracetic acid disinfectant solution)(P>0.05),and the economic cost of disinfectant required per endoscope was lower(1.5 China Yuan),with a shorter disinfection time(30 minutes).CONCLUSION The methods and results of this study provide a basis for further research on the use of VHP for the disinfection of gastrointestinal endoscopes,as well as for the development of anhydrous disinfection technology for gastrointestinal endoscopes.展开更多
Objective:To evaluate the application value of lean management in the management of flexible endoscopes.Methods:From January to December 2023,routine management was implemented,and 200 flexible endoscopes used for exa...Objective:To evaluate the application value of lean management in the management of flexible endoscopes.Methods:From January to December 2023,routine management was implemented,and 200 flexible endoscopes used for examination and treatment were included in the control group;from January to December 2024,lean management was implemented,and 200 flexible endoscopes used for examination and treatment were included in the observation group.The average daily usage frequency,management effectiveness,and failure rate of flexible endoscopes were compared between the two groups.Results:The average daily usage frequency of flexible endoscopes in the observation group was higher than that in the control group(P<0.05);the 3S retrieval rate and spot-check qualification rate of endoscopes in the observation group were higher than those in the control group(P<0.05);the failure rate of flexible endoscopes in the observation group was lower than that in the control group(P<0.05).Conclusion:Implementing lean management during the management of flexible endoscopes can improve the efficiency of endoscope retrieval,increase the average daily usage frequency of flexible endoscopes,and reduce endoscope failures.展开更多
BACKGROUND Commonly used cleaning brushes in the reprocessing of flexible endoscopes often cause damage within the working channels.AIM To develop a spray flushing system to achieving effective cleaning of the working...BACKGROUND Commonly used cleaning brushes in the reprocessing of flexible endoscopes often cause damage within the working channels.AIM To develop a spray flushing system to achieving effective cleaning of the working channels while minimizing damage.METHODS This prospective study included 60 used endoscopes and 60 Teflon tubes randomly divided into a control group(n=30)and an experimental group(n=30).The material of Teflon tubes was the same as that of the endoscope working channel.Endoscopes in the control group were manually cleaned using traditional cleaning brushes,while those in the experimental group were cleaned using the newly developed spray flushing system.ATP levels,cleanliness,and microbiological testing of the working channels were measured.Additionally,Teflon tubes in the control group underwent 500 passes with a cleaning brush,while those in the experimental group were subjected to the spray flushing system,and channel damage was evaluated.RESULTS The ATP levels(RLU)in the two groups were 32.5(13-66)and 26(16-40),respectively(P>0.05).Cleanliness scores were 1.5(1-2)and 1(1-2),respectively(P>0.05).Debris was found in 73.3%of the control group,which was significantly higher than 46.7%in the experimental group(P<0.05).Microbiological tests for both groups yielded negative results.Teflon tube damage in the control group was rated at 4(4-5.25),which was significantly higher than in the experimental group 4(3-4)(P<0.01).CONCLUSION The spray flushing system demonstrated superior efficacy in removing debris and resulted in less damage to the endoscope working channels compared with traditional cleaning brushes.展开更多
We recently read with great interest a study by Zhang et al in the World Journal of Gastroenterology.In our practice,we focus specifically on examining appendiceal mucinous neoplasms(AMNs)with endoscopic ultrasound(EU...We recently read with great interest a study by Zhang et al in the World Journal of Gastroenterology.In our practice,we focus specifically on examining appendiceal mucinous neoplasms(AMNs)with endoscopic ultrasound(EUS)using different scopes.AMNs are rare neoplastic lesions characterized by an accumulation of mucin inside a cystic dilatation of the appendix.Clinically,they can present as nonspecific acute appendicitis.AMNs can turn into a life-threatening condition,termed pseudomyxoma peritonei,in which the ruptured appendix causes accumulation of mucin in the abdomen.Therefore,accurate and rapid diagnosis of AMN is essential.EUS is able to confirm and stage AMNs;although,EUS examination was once limited to the rectal and anal regions due to the conven-tional oblique-view scopes.With the emergence of new forward-view linear echoendoscopes and instruments like EUS miniprobes and overtubes,the scope of examination is changing.Herein,we discuss the feasibility of using the curved linear array echoendoscopes to examine cecal and appendiceal orifice lesions.展开更多
Airborne transmission is among the most frequent types of nosocomial infection.Recent years have witnessed frequent outbreaks of airborne diseases,such as severe acute respiratory syndrome(SARS)in 2002,Middle East res...Airborne transmission is among the most frequent types of nosocomial infection.Recent years have witnessed frequent outbreaks of airborne diseases,such as severe acute respiratory syndrome(SARS)in 2002,Middle East respiratory syndrome(MERS)in 2012,and coronavirus disease 2019(COVID-19),with the latter being on the rampage since the end of 2019 and bringing the effect of aerosols on health back to the fore(Gralton et al.,2011;Wang et al.,2021).An increasing number of studies have shown that certain highly transmissible pathogens can maintain long-term stability and efficiently spread through aerosols(Leung,2021;Lv et al.,2021).As reported previously,influenza viruses that can spread efficiently through aerosols remain stable for a longer period compared to those that cannot.The World Health Organization(WHO)has stated that aerosol-generating procedures(AGPs)play an important role in aerosol transmission in hospitals(Calderwood et al.,2021).AGPs,referring to medical procedures that produce aerosols,including dental procedures,endotracheal intubation,sputum aspiration,and laparoscopic surgeries,have been reported to be significantly associated with an increased risk of nosocomial infection among medical personnel(Hamilton,2021).展开更多
Acute appendicitis is a common surgical emergency.It is commonly caused by obstruction of the appendiceal lumen due to fecaliths,tumors,or lymphoid hyperplasia.For over a century,appendectomy has been the primary trea...Acute appendicitis is a common surgical emergency.It is commonly caused by obstruction of the appendiceal lumen due to fecaliths,tumors,or lymphoid hyperplasia.For over a century,appendectomy has been the primary treatment for acute appendicitis.Abraham Groves performed the first open appendectomy in 1883.In 1983,Kurt Semm completed the first laparoscopic appendectomy,heralding a new era in appendectomy.However,appendectomy is associated with certain complications and a rate of negative appendectomies.Studies have suggested controversy over the impact of appendectomy on the development of inflammatory bowel disease and Parkinson’s disease,but an increasing number of studies indicate a possible positive correlation between appendectomy and colorectal cancer,gallstones,and cardiovascular disease.With the recognition that the appendix is not a vestigial organ and the advancement of endoscopic technology,Liu proposed the endoscopic retrograde appendicitis therapy.It is an effective minimally invasive alternative for treating uncomplicated acute appendicitis.Our team has developed an appendoscope with a disposable digital imaging system operated through the biopsy channel of a colonoscope and successfully applied it in the treatment of appendicitis.This article provides an overview of the progress in endoscopic treatment for acute appendicitis and offers a new perspective on the future direction of appendiceal disease treatment.展开更多
Optical endoscopy has become an essential diagnostic and therapeutic approach in modern biomedicine for directly observing organs and tissues deep inside the human body,enabling non-invasive,rapid diagnosis and treatm...Optical endoscopy has become an essential diagnostic and therapeutic approach in modern biomedicine for directly observing organs and tissues deep inside the human body,enabling non-invasive,rapid diagnosis and treatment.Optical fiber endoscopy is highly competitive among various endoscopic imaging techniques due to its high flexibility,compact structure,excellent resolution,and resistance to electromagnetic interference.Over the past decade,endoscopes based on a single multimode optical fiber(MMF)have attracted widespread research interest due to their potential to significantly reduce the footprint of optical fiber endoscopes and enhance imaging capabilities.In comparison with other imaging principles of MMF endoscopes,the scanning imaging method based on the wavefront shaping technique is highly developed and provides benefits including excellent imaging contrast,broad applicability to complex imaging scenarios,and good compatibility with various well-established scanning imaging modalities.In this review,various technical routes to achieve light focusing through MMF and procedures to conduct the scanning imaging of MMF endoscopes are introduced.The advancements in imaging performance enhancements,integrations of various imaging modalities with MMF scanning endoscopes,and applications are summarized.Challenges specific to this endoscopic imaging technology are analyzed,and potential remedies and avenues for future developments are discussed.展开更多
Blast furnace(BF)burden surface contains the most abundant,intuitive and credible smelting information and acquiring high-definition and high-brightness optical images of which is essential to realize precise material...Blast furnace(BF)burden surface contains the most abundant,intuitive and credible smelting information and acquiring high-definition and high-brightness optical images of which is essential to realize precise material charging control,optimize gas flow distribution and improve ironmaking efficiency.It has been challengeable to obtain high-quality optical burden surface images under high-temperature,high-dust,and extremelydim(less than 0.001 Lux)environment.Based on a novel endoscopic sensing detection idea,a reverse telephoto structure starlight imaging system with large field of view and large aperture is designed.Combined with a water-air dual cooling intelligent self-maintenance protection device and the imaging system,a starlight high-temperature industrial endoscope is developed to obtain clear optical burden surface images stably under the harsh environment.Based on an endoscope imaging area model,a material flow trajectory model and a gas-dust coupling distribution model,an optimal installation position and posture configuration method for the endoscope is proposed,which maximizes the effective imaging area and ensures large-area,safe and stable imaging of the device in a confined space.Industrial experiments and applications indicate that the proposed method obtains clear and reliable large-area optical burden surface images and reveals new BF conditions,providing key data support for green iron smelting.展开更多
Oral endoscope image stitching algorithm is studied to obtain wide-field oral images through regis-tration and stitching,which is of great significance for auxiliary diagnosis.Compared with natural images,oral images ...Oral endoscope image stitching algorithm is studied to obtain wide-field oral images through regis-tration and stitching,which is of great significance for auxiliary diagnosis.Compared with natural images,oral images have lower textures and fewer features.However,traditional feature-based image stitching methods rely heavily on feature extraction quality,often showing an unsatisfactory performance when stitching images with few features.Moreover,due to the hand-held shooting,there are large depth and perspective disparities between the captured images,which also pose a challenge to image stitching.To overcome the above problems,we propose an unsupervised oral endoscope image stitching algorithm based on the extraction of overlapping regions and the loss of deep features.In the registration stage,we extract the overlapping region of the input images by sketching polygon intersection for feature points screening and estimate homography from coarse to fine on a three-layer feature pyramid structure.Moreover,we calculate loss using deep features instead of pixel values to emphasize the importance of depth disparities in homography estimation.Finally,we reconstruct the stitched images from feature to pixel,which can eliminate artifacts caused by large parallax.Our method is compared with both feature-based and previous deep-based methods on the UDIS-D dataset and our oral endoscopy image dataset.The experimental results show that our algorithm can achieve higher homography estimation accuracy,and better visual quality,and can be effectively applied to oral endoscope image stitching.展开更多
Stapes surgery is the gold standard for managing otosclerosis.It has become increasingly appreciated to perform endoscopic ear surgery worldwide as the field of endoscopy expands.In basic terms,a stapes surgery intend...Stapes surgery is the gold standard for managing otosclerosis.It has become increasingly appreciated to perform endoscopic ear surgery worldwide as the field of endoscopy expands.In basic terms,a stapes surgery intends to restore ossicular mobility and therefore improve sound energy transduction into the inner ear,thereby improving communication and sound amplification and bringing hearing levels back to acceptable levels.The aim of the study is to analyze surgical techniques comparing microscopic and endoscopic approaches for stapes surgery.The perspectives of Surgical Pioneers in Early Stapes Surgery and the contemporary development of surgical technology will be explored as well.Specifically,this study compiles well-documented,reliable information concerning the surgical outcomes for the endoscopic approach to stapes surgery and the results of recent studies.展开更多
This study aimed to determine the guide function of the number of gastrointestinal endoscope cases for the endoscopic submucosal dissection training of early gastric cancer.Three physicians in our center who began to ...This study aimed to determine the guide function of the number of gastrointestinal endoscope cases for the endoscopic submucosal dissection training of early gastric cancer.Three physicians in our center who began to learn ESD in July 2021 are selected and designate them as operators 1⁃3.The number of gastrointestinal endoscope cases performed by operators 1⁃3 before June 2021 was extracted,and the dissection speed among different operators in the ESD training stage was compared.The number of gastrointestinal endoscope cases performed by operator 1 was 3677,that by operator 2 was 4897 and that by operator 3 was 9249.The average dissection speed of operator 1 was 0.132 cm^(2)/min,operator 2 was 0.145 cm^(2)/min,and operator 3 was 0.174 cm^(2)/min.The dissection speed was ranked as operator 1<operator 2<operator 3,and one case of R0 resection was not achieved in both operator 1 and operator 2.Operator 3 achieved R0 resection in all 10 patients.With the increasing of number of gastrointestinal endoscope cases,the dissection speed and the stability of operation of endoscopists in the ESD training will increase.展开更多
AIM To assess the feasibility and safety of a novel enteroscope,negative-pressure suction endoscope in examining the small intestine of a porcine model.METHODS In vitro experiments in small intestinal loops from 20pig...AIM To assess the feasibility and safety of a novel enteroscope,negative-pressure suction endoscope in examining the small intestine of a porcine model.METHODS In vitro experiments in small intestinal loops from 20pigs and in vivo experiments in 20 living pigs were conducted.RESULTS In in vitro experiments,a negative pressure of>0.06MPa was necessary for optimal visualization of the intestine,and this pressure did not cause gross or histological damage to the mucosa.For satisfactory examination of the small intestine in vivo,higher negative pressure(>1.00 MPa)was required.Despite this higher pressure,the small intestine did not show any gross or microscopic damage in the suctioned areas.The average time of examination in the living animals was 60±7.67 min.The animals did not experience any apparent ill effects from the procedure.CONCLUSION Small intestine endoscope was safely performed within a reasonable time period and enabled complete visualization of the intestine in most cases.展开更多
A 2.4GHz ASK transmitter suitable for a low power wireless capsule endoscope system is presented. A mixer-based frequency up-conversion transmitter architecture is employed to achieve a high data rate. A pseudodiffere...A 2.4GHz ASK transmitter suitable for a low power wireless capsule endoscope system is presented. A mixer-based frequency up-conversion transmitter architecture is employed to achieve a high data rate. A pseudodifferential stacked class-A power amplifier using the current reuse technique is proposed to save power. The transmitter mainly includes two parts： a 20MHz ASK modulator based on a constant amplitude phase lock loop （PLL） and a direct up-conversion RF circuit. This design, implemented in a TSMC 0.25μm CMOS process, achieves a - 23. 217dBm output power with a data rate of 1Mbps and dissipates 3.17mA of current with a single 2.5V power supply.展开更多
AIM: To describe and evaluate a new ophthalmic endoscope surgical technique combined with phacoe-mulsification and intraocular lens (IOL) implantation to treat goniosynechialysis and manage primary angle-closure glauc...AIM: To describe and evaluate a new ophthalmic endoscope surgical technique combined with phacoe-mulsification and intraocular lens (IOL) implantation to treat goniosynechialysis and manage primary angle-closure glaucoma (PACG). ·METHODS: Endoscope-assisted goniosynechialysis combined with phacoemulsification and IOL implantation was performed in 32 eyes of 29 patients with PACG. Regular follow-up was performed 1 week and 1 month, 3, and 6 months after surgery to assess complications, intraocular pressure (IOP), anterior chamber depth, visual acuity, and anterior chamber angle. ·RESULTS: Preoperative mean IOP was 24.88±7.22mmHg with pharmacological treatment, and was 13.70 ±4.02, 13.06 ±3.74, 14.29 ±4.70, and 14.33 ±5.01mmHg 1 week, 1 month, 3 months, and 6 months after surgery, respectively. The postoperative decrease in IOP was significant (P 【 0.05). The rate for all eyes with IOP of 21mmHg or less was 93.8% (30 eyes) at the final visit without ocular hypotensive agents. The average preoperative anterior chamber depth was 1.60 ±0.64mm, and this value significantly increased to 2.72±0.62, 2.76±0.70, 2.73±0.68, and 2.74 ±0.71mm at 1 week, 1 month, 3 months, and 6 months, respectively. Visual acuity was improved in 28 eyes (87.5% ) at 6 months postoperatively. The anterior chamber angle had increased in 25 eyes (78.1% ) at the final visit; it was adhesive 90°-180° in 6 eyes, 180°-270° in only 1 eye. Two eyes exhibited minimal hyphema in the early postoperative period, but it could gradually be absorbed. Fibrinous reaction was observed in five eyes and spontaneously disappeared within 7 days. No shallow anterior chamber, iridodialysis, choroidal deta-chment, or malignant glaucoma was found in any eyes.CONCLUSION:Endoscope-assisted goniosynechialysis combined with phacoemulsification and IOL implantation to manage PACG has several advantages, including optimized visualization, greater accuracy, and improved safety. Our results suggest that it has certain curative effects and clinical application value.展开更多
BACKGROUND Conventionally, the low luminous intensity, low image resolution, and difficulty in operation have been reported with the ultrathin endoscope. However, it has markedly advanced recently. The improvement of ...BACKGROUND Conventionally, the low luminous intensity, low image resolution, and difficulty in operation have been reported with the ultrathin endoscope. However, it has markedly advanced recently. The improvement of the diagnostic ability is expected.AIM To compare the early gastric cancer diagnostic ability of an ultrathin endoscope loaded with a laser light source and that of the conventional endoscope.METHODS The target subjects were 375 consecutive patients who underwent endoscopy at our hospital for post-endoscopic submucosal dissection follow-up of gastric cancer from January to August 2018. During endoscopy, the ultrathin endoscope was used in 140 patients(37.3%), and the conventional endoscope was used in235 patients(62.7%). Patient background was adjusted using the propensity score matching method, and gastric cancer detection ability was evaluated in the two groups.RESULTS The gastric cancer detection rate was 7.8% in the ultrathin endoscope group and7.0% in the conventional endoscope group, and the mean intragastric observation time was 4.1 ± 1.7 min in the ultrathin endoscope group and 4.1 ± 1.9 min in the conventional endoscope group, showing no significant differences between the groups. Moreover, the biopsy implementation rate was 31.8% in the ultrathin endoscope group and 41.1% in the conventional endoscope group, and the biopsy prediction rate was 17.9% and 13.2%, respectively, showing no significant differences between the groups.CONCLUSION The gastric cancer diagnostic ability of the ultrathin endoscope loaded with a laser light source was comparable to that of the conventional endoscope. The observation time was also comparable. Thus, endoscopy using the ultrathin endoscope loaded with the laser light source would be the first option in screening examinations of gastric cancer due to its low invasion.展开更多
Objectives： This pilot study of employing chlorine dioxide （CD） gas to disinfect gastrointestinal endoscopes was conducted to meet the expectations of many endoscopy units in China for a high-efficiency and low-cos...Objectives： This pilot study of employing chlorine dioxide （CD） gas to disinfect gastrointestinal endoscopes was conducted to meet the expectations of many endoscopy units in China for a high-efficiency and low-cost disin- fectant. Methods： An experimental prototype with an active circulation mode was designed to use CD gas to disinfect gastrointestinal endoscopes. One type of testing device composed of polytetrafluoroethylene （PTFE） tubes （2 m long, inner diameter 1 mm） and bacterial carrier containers was used to simulate the channel of the endoscope. PTFE bacterial carriers inoculated with Bacillus atrophaeus with or without organic burden were used to evaluate the spor- icidal activity of CD gas. Factors including exposure dosage, relative humidity （RH）, and flow rate （FR） influencing the disinfection effect of CD gas were investigated. Moreover, an autoptic disinfecting test on eight real gastrointestinal endoscopes after clinical use was performed using the experimental prototype. Results： IRH, exposure dosage, or- ganic burden, and the FIR through the channel significantly （P〈0.05） affected the disinfection efficacy of CD gas for a long and narrow lumen. The log reduction increased as FR decreased. Treatment with 4 mg/L CD gas for 30 min at 0.8 L/min FR and 75% IRH, resulted in complete inactivation of spores. Furthermore, all eight endoscopes with a maximum colony-forming unit of 915 were completely disinfected. The cost was only 3 CNY （0.46 USD） for each endoscope. Conclusions： The methods and results reported in this study could provide a basis for further studies on using CD gas for the disinfection of endoscopes.展开更多
文摘This article comments on the article by Du et al,who conducted a randomized controlled trial aiming at evaluating the effectiveness of a novel spray flushing system in cleaning flexible endoscopes while minimizing damage to the working channels.We share our perspective on the importance of improving endoscope reprocessing methods.The findings highlight the spray flushing system's capacity to improve cleaning efficacy while minimizing damage,suggesting that it might be important in enhancing endoscope reprocessing procedures.
基金Supported by the National Natural Science Foundation of China,No.81602056 and No.82273393the Young Talents Promotion Project of Shandong Medical Association in 2023,No.2023_GJ_0087.
文摘Digestive endoscopy has been widely used in the diagnosis and treatment of digestive diseases.However,the anatomical complexity of specific lesions increases the difficulty of these operations,resulting in complications or treatment failure.Although various strategies,such as floss traction and the application of transparent caps,have been explored,their effectiveness remains limited due to individual differences in patients’anatomical characteristics.The multibending(MB)endoscope represents a significant innovation as it is a conventional endoscope with an additional bending section and dual channels.Currently,this technology has been applied in gastroscopy,duodenoscopy and peroral cholangioscopy.The bending part of the endoscope facilitates its passage into difficult-to-reach anatomical regions and improves operating angles,thereby enhancing surgical precision and efficiency while reducing complication rates.Furthermore,the dualchannel design accelerates procedural workflows and increases operational versatility.This innovation is poised to transform endoscopic diagnosis and treatment of digestive system diseases.Since the MB endoscope is relatively new,further research is needed to comprehensively explore its benefits for and potential in endoscopic diagnosis and treatment.The aim of this review is to summarize the current research,indications,and future directions of MB endoscope.
文摘As the cornerstone of sterile instrument maintenance in endoscopy centers,the quality of endoscope cleaning directly impacts hospital infection control effectiveness.The traceability system for endoscopy centers utilizes digital means to document the entire cleaning process,enabling real-time monitoring and precise quality control.This paper analyzes current quality control practices in endoscope cleaning and addresses existing challenges.It explores how traceability systems standardize procedures,enhance monitoring,and improve management efficiency.The study proposes optimization strategies for traceability system implementation,clarifying its core value in endoscope cleaning quality control.These findings provide theoretical foundations and practical guidance for hospitals to refine management of endoscopy centers,ensure diagnostic safety,and reduce infection risks,ultimately advancing endoscope cleaning quality control toward standardized and informatized development.
文摘The advancement in endoscopic technology and techniques has increased its use in the diagnosis and treatment of gastrointestinal diseases.Reprocessing of reusable endoscopes remains a challenge.Inadequate reprocessing leads to bacterial contamination of the endoscope,a significant cause of endoscope-related infections.To thoroughly address the complexities of cleaning a flexible endo-scope,various cleaning methods have been devised and tested across different studies.This letter evaluates one such method,spray flushing for flexible gastro-scopes,developed and tested in a randomized controlled trial by Du et al.Based on the post-processing test results for this method,Du et al conclude that there is improved cleaning efficacy and reduced damage compared to manual brush cleaning.The validity and reliability of the results could be further enhanced by carefully considering the study design and a few underlying concepts that contribute to the reprocessing quality of different types of endoscopes.
基金Supported by the Joint Logistics Support Force Comprehensive Equipment Research Project,No.LB2023B010100-09.
文摘BACKGROUND Current disinfection methods for gastrointestinal endoscopes consume a significant amount of water resources and produce a large volume of waste.AIM To achieve the objectives of efficiency,speed,and cost-effectiveness,this study utilized vaporized hydrogen peroxide(VHP)generated from sodium percarbonate granules to conduct an anhydrous disinfection test on gastrointestinal endoscopes.METHODS The experimental device rapidly converts sodium percarbonate granules into VHP,and performs disinfection experiments on gastrointestinal endoscope models,disposable endoscopes,and various types of reusable gastrointestinal endoscopes.Variables such as the intraluminal flow rate(FR),relative humidity(RH),exposure dosage,and organic burden are used to explore the factors influencing the disinfection of long and narrow lumens with VHP.RESULTS The device generates a certain concentration of VHP that can achieve high-level disinfection of endoscope models within 30 minutes.RH,exposure dosage,and organic burden significantly affect the disinfection efficacy of VHP,whereas the intraluminal FR does not significantly impact disinfection efficacy.All ten artificially contaminated disposable endoscopes achieved satisfactory disinfection results.Furthermore,when this device was used to treat various types of reusable endoscopes,the disinfection and sterilization effects were not significantly different from those of automatic endoscope disinfection machines(using peracetic acid disinfectant solution)(P>0.05),and the economic cost of disinfectant required per endoscope was lower(1.5 China Yuan),with a shorter disinfection time(30 minutes).CONCLUSION The methods and results of this study provide a basis for further research on the use of VHP for the disinfection of gastrointestinal endoscopes,as well as for the development of anhydrous disinfection technology for gastrointestinal endoscopes.
文摘Objective:To evaluate the application value of lean management in the management of flexible endoscopes.Methods:From January to December 2023,routine management was implemented,and 200 flexible endoscopes used for examination and treatment were included in the control group;from January to December 2024,lean management was implemented,and 200 flexible endoscopes used for examination and treatment were included in the observation group.The average daily usage frequency,management effectiveness,and failure rate of flexible endoscopes were compared between the two groups.Results:The average daily usage frequency of flexible endoscopes in the observation group was higher than that in the control group(P<0.05);the 3S retrieval rate and spot-check qualification rate of endoscopes in the observation group were higher than those in the control group(P<0.05);the failure rate of flexible endoscopes in the observation group was lower than that in the control group(P<0.05).Conclusion:Implementing lean management during the management of flexible endoscopes can improve the efficiency of endoscope retrieval,increase the average daily usage frequency of flexible endoscopes,and reduce endoscope failures.
基金West China Nursing Discipline Development Special Fund Project,No.HXHL21029。
文摘BACKGROUND Commonly used cleaning brushes in the reprocessing of flexible endoscopes often cause damage within the working channels.AIM To develop a spray flushing system to achieving effective cleaning of the working channels while minimizing damage.METHODS This prospective study included 60 used endoscopes and 60 Teflon tubes randomly divided into a control group(n=30)and an experimental group(n=30).The material of Teflon tubes was the same as that of the endoscope working channel.Endoscopes in the control group were manually cleaned using traditional cleaning brushes,while those in the experimental group were cleaned using the newly developed spray flushing system.ATP levels,cleanliness,and microbiological testing of the working channels were measured.Additionally,Teflon tubes in the control group underwent 500 passes with a cleaning brush,while those in the experimental group were subjected to the spray flushing system,and channel damage was evaluated.RESULTS The ATP levels(RLU)in the two groups were 32.5(13-66)and 26(16-40),respectively(P>0.05).Cleanliness scores were 1.5(1-2)and 1(1-2),respectively(P>0.05).Debris was found in 73.3%of the control group,which was significantly higher than 46.7%in the experimental group(P<0.05).Microbiological tests for both groups yielded negative results.Teflon tube damage in the control group was rated at 4(4-5.25),which was significantly higher than in the experimental group 4(3-4)(P<0.01).CONCLUSION The spray flushing system demonstrated superior efficacy in removing debris and resulted in less damage to the endoscope working channels compared with traditional cleaning brushes.
文摘We recently read with great interest a study by Zhang et al in the World Journal of Gastroenterology.In our practice,we focus specifically on examining appendiceal mucinous neoplasms(AMNs)with endoscopic ultrasound(EUS)using different scopes.AMNs are rare neoplastic lesions characterized by an accumulation of mucin inside a cystic dilatation of the appendix.Clinically,they can present as nonspecific acute appendicitis.AMNs can turn into a life-threatening condition,termed pseudomyxoma peritonei,in which the ruptured appendix causes accumulation of mucin in the abdomen.Therefore,accurate and rapid diagnosis of AMN is essential.EUS is able to confirm and stage AMNs;although,EUS examination was once limited to the rectal and anal regions due to the conven-tional oblique-view scopes.With the emergence of new forward-view linear echoendoscopes and instruments like EUS miniprobes and overtubes,the scope of examination is changing.Herein,we discuss the feasibility of using the curved linear array echoendoscopes to examine cecal and appendiceal orifice lesions.
基金supported by the Medicine and Health Care in Zhejiang Province Science and Technology Plan Projects(Nos.2020KY552 and 2021PY006)the Commonweal Project of Science and Technology Department of Zhejiang Province(No.LGF21H030007),China.
文摘Airborne transmission is among the most frequent types of nosocomial infection.Recent years have witnessed frequent outbreaks of airborne diseases,such as severe acute respiratory syndrome(SARS)in 2002,Middle East respiratory syndrome(MERS)in 2012,and coronavirus disease 2019(COVID-19),with the latter being on the rampage since the end of 2019 and bringing the effect of aerosols on health back to the fore(Gralton et al.,2011;Wang et al.,2021).An increasing number of studies have shown that certain highly transmissible pathogens can maintain long-term stability and efficiently spread through aerosols(Leung,2021;Lv et al.,2021).As reported previously,influenza viruses that can spread efficiently through aerosols remain stable for a longer period compared to those that cannot.The World Health Organization(WHO)has stated that aerosol-generating procedures(AGPs)play an important role in aerosol transmission in hospitals(Calderwood et al.,2021).AGPs,referring to medical procedures that produce aerosols,including dental procedures,endotracheal intubation,sputum aspiration,and laparoscopic surgeries,have been reported to be significantly associated with an increased risk of nosocomial infection among medical personnel(Hamilton,2021).
基金Supported by the Construction Fund of Key Medical Disciplines of Hangzhou,No.0020200026Key R&D Program of Zhejiang Province,No.2023C03054.
文摘Acute appendicitis is a common surgical emergency.It is commonly caused by obstruction of the appendiceal lumen due to fecaliths,tumors,or lymphoid hyperplasia.For over a century,appendectomy has been the primary treatment for acute appendicitis.Abraham Groves performed the first open appendectomy in 1883.In 1983,Kurt Semm completed the first laparoscopic appendectomy,heralding a new era in appendectomy.However,appendectomy is associated with certain complications and a rate of negative appendectomies.Studies have suggested controversy over the impact of appendectomy on the development of inflammatory bowel disease and Parkinson’s disease,but an increasing number of studies indicate a possible positive correlation between appendectomy and colorectal cancer,gallstones,and cardiovascular disease.With the recognition that the appendix is not a vestigial organ and the advancement of endoscopic technology,Liu proposed the endoscopic retrograde appendicitis therapy.It is an effective minimally invasive alternative for treating uncomplicated acute appendicitis.Our team has developed an appendoscope with a disposable digital imaging system operated through the biopsy channel of a colonoscope and successfully applied it in the treatment of appendicitis.This article provides an overview of the progress in endoscopic treatment for acute appendicitis and offers a new perspective on the future direction of appendiceal disease treatment.
基金supported by National Natural Science Foundation of China(62135007 and 61925502).
文摘Optical endoscopy has become an essential diagnostic and therapeutic approach in modern biomedicine for directly observing organs and tissues deep inside the human body,enabling non-invasive,rapid diagnosis and treatment.Optical fiber endoscopy is highly competitive among various endoscopic imaging techniques due to its high flexibility,compact structure,excellent resolution,and resistance to electromagnetic interference.Over the past decade,endoscopes based on a single multimode optical fiber(MMF)have attracted widespread research interest due to their potential to significantly reduce the footprint of optical fiber endoscopes and enhance imaging capabilities.In comparison with other imaging principles of MMF endoscopes,the scanning imaging method based on the wavefront shaping technique is highly developed and provides benefits including excellent imaging contrast,broad applicability to complex imaging scenarios,and good compatibility with various well-established scanning imaging modalities.In this review,various technical routes to achieve light focusing through MMF and procedures to conduct the scanning imaging of MMF endoscopes are introduced.The advancements in imaging performance enhancements,integrations of various imaging modalities with MMF scanning endoscopes,and applications are summarized.Challenges specific to this endoscopic imaging technology are analyzed,and potential remedies and avenues for future developments are discussed.
基金the National Natural Science Foundation of China(62273359)the General Project of Hunan Natural Science Foundation of China(2022JJ30748)the National Major Scientific Research Equipment of China(61927803)。
文摘Blast furnace(BF)burden surface contains the most abundant,intuitive and credible smelting information and acquiring high-definition and high-brightness optical images of which is essential to realize precise material charging control,optimize gas flow distribution and improve ironmaking efficiency.It has been challengeable to obtain high-quality optical burden surface images under high-temperature,high-dust,and extremelydim(less than 0.001 Lux)environment.Based on a novel endoscopic sensing detection idea,a reverse telephoto structure starlight imaging system with large field of view and large aperture is designed.Combined with a water-air dual cooling intelligent self-maintenance protection device and the imaging system,a starlight high-temperature industrial endoscope is developed to obtain clear optical burden surface images stably under the harsh environment.Based on an endoscope imaging area model,a material flow trajectory model and a gas-dust coupling distribution model,an optimal installation position and posture configuration method for the endoscope is proposed,which maximizes the effective imaging area and ensures large-area,safe and stable imaging of the device in a confined space.Industrial experiments and applications indicate that the proposed method obtains clear and reliable large-area optical burden surface images and reveals new BF conditions,providing key data support for green iron smelting.
基金the National Natural Science Foundation of China(No.61976091)。
文摘Oral endoscope image stitching algorithm is studied to obtain wide-field oral images through regis-tration and stitching,which is of great significance for auxiliary diagnosis.Compared with natural images,oral images have lower textures and fewer features.However,traditional feature-based image stitching methods rely heavily on feature extraction quality,often showing an unsatisfactory performance when stitching images with few features.Moreover,due to the hand-held shooting,there are large depth and perspective disparities between the captured images,which also pose a challenge to image stitching.To overcome the above problems,we propose an unsupervised oral endoscope image stitching algorithm based on the extraction of overlapping regions and the loss of deep features.In the registration stage,we extract the overlapping region of the input images by sketching polygon intersection for feature points screening and estimate homography from coarse to fine on a three-layer feature pyramid structure.Moreover,we calculate loss using deep features instead of pixel values to emphasize the importance of depth disparities in homography estimation.Finally,we reconstruct the stitched images from feature to pixel,which can eliminate artifacts caused by large parallax.Our method is compared with both feature-based and previous deep-based methods on the UDIS-D dataset and our oral endoscopy image dataset.The experimental results show that our algorithm can achieve higher homography estimation accuracy,and better visual quality,and can be effectively applied to oral endoscope image stitching.
文摘Stapes surgery is the gold standard for managing otosclerosis.It has become increasingly appreciated to perform endoscopic ear surgery worldwide as the field of endoscopy expands.In basic terms,a stapes surgery intends to restore ossicular mobility and therefore improve sound energy transduction into the inner ear,thereby improving communication and sound amplification and bringing hearing levels back to acceptable levels.The aim of the study is to analyze surgical techniques comparing microscopic and endoscopic approaches for stapes surgery.The perspectives of Surgical Pioneers in Early Stapes Surgery and the contemporary development of surgical technology will be explored as well.Specifically,this study compiles well-documented,reliable information concerning the surgical outcomes for the endoscopic approach to stapes surgery and the results of recent studies.
基金supported by National Key Research and Development Program of China(2022YFC2503600)Chinese PLA General Hospital Young Independent Innovation Science Fund(22QNFC072).
文摘This study aimed to determine the guide function of the number of gastrointestinal endoscope cases for the endoscopic submucosal dissection training of early gastric cancer.Three physicians in our center who began to learn ESD in July 2021 are selected and designate them as operators 1⁃3.The number of gastrointestinal endoscope cases performed by operators 1⁃3 before June 2021 was extracted,and the dissection speed among different operators in the ESD training stage was compared.The number of gastrointestinal endoscope cases performed by operator 1 was 3677,that by operator 2 was 4897 and that by operator 3 was 9249.The average dissection speed of operator 1 was 0.132 cm^(2)/min,operator 2 was 0.145 cm^(2)/min,and operator 3 was 0.174 cm^(2)/min.The dissection speed was ranked as operator 1<operator 2<operator 3,and one case of R0 resection was not achieved in both operator 1 and operator 2.Operator 3 achieved R0 resection in all 10 patients.With the increasing of number of gastrointestinal endoscope cases,the dissection speed and the stability of operation of endoscopists in the ESD training will increase.
文摘AIM To assess the feasibility and safety of a novel enteroscope,negative-pressure suction endoscope in examining the small intestine of a porcine model.METHODS In vitro experiments in small intestinal loops from 20pigs and in vivo experiments in 20 living pigs were conducted.RESULTS In in vitro experiments,a negative pressure of>0.06MPa was necessary for optimal visualization of the intestine,and this pressure did not cause gross or histological damage to the mucosa.For satisfactory examination of the small intestine in vivo,higher negative pressure(>1.00 MPa)was required.Despite this higher pressure,the small intestine did not show any gross or microscopic damage in the suctioned areas.The average time of examination in the living animals was 60±7.67 min.The animals did not experience any apparent ill effects from the procedure.CONCLUSION Small intestine endoscope was safely performed within a reasonable time period and enabled complete visualization of the intestine in most cases.
文摘A 2.4GHz ASK transmitter suitable for a low power wireless capsule endoscope system is presented. A mixer-based frequency up-conversion transmitter architecture is employed to achieve a high data rate. A pseudodifferential stacked class-A power amplifier using the current reuse technique is proposed to save power. The transmitter mainly includes two parts： a 20MHz ASK modulator based on a constant amplitude phase lock loop （PLL） and a direct up-conversion RF circuit. This design, implemented in a TSMC 0.25μm CMOS process, achieves a - 23. 217dBm output power with a data rate of 1Mbps and dissipates 3.17mA of current with a single 2.5V power supply.
文摘AIM: To describe and evaluate a new ophthalmic endoscope surgical technique combined with phacoe-mulsification and intraocular lens (IOL) implantation to treat goniosynechialysis and manage primary angle-closure glaucoma (PACG). ·METHODS: Endoscope-assisted goniosynechialysis combined with phacoemulsification and IOL implantation was performed in 32 eyes of 29 patients with PACG. Regular follow-up was performed 1 week and 1 month, 3, and 6 months after surgery to assess complications, intraocular pressure (IOP), anterior chamber depth, visual acuity, and anterior chamber angle. ·RESULTS: Preoperative mean IOP was 24.88±7.22mmHg with pharmacological treatment, and was 13.70 ±4.02, 13.06 ±3.74, 14.29 ±4.70, and 14.33 ±5.01mmHg 1 week, 1 month, 3 months, and 6 months after surgery, respectively. The postoperative decrease in IOP was significant (P 【 0.05). The rate for all eyes with IOP of 21mmHg or less was 93.8% (30 eyes) at the final visit without ocular hypotensive agents. The average preoperative anterior chamber depth was 1.60 ±0.64mm, and this value significantly increased to 2.72±0.62, 2.76±0.70, 2.73±0.68, and 2.74 ±0.71mm at 1 week, 1 month, 3 months, and 6 months, respectively. Visual acuity was improved in 28 eyes (87.5% ) at 6 months postoperatively. The anterior chamber angle had increased in 25 eyes (78.1% ) at the final visit; it was adhesive 90°-180° in 6 eyes, 180°-270° in only 1 eye. Two eyes exhibited minimal hyphema in the early postoperative period, but it could gradually be absorbed. Fibrinous reaction was observed in five eyes and spontaneously disappeared within 7 days. No shallow anterior chamber, iridodialysis, choroidal deta-chment, or malignant glaucoma was found in any eyes.CONCLUSION:Endoscope-assisted goniosynechialysis combined with phacoemulsification and IOL implantation to manage PACG has several advantages, including optimized visualization, greater accuracy, and improved safety. Our results suggest that it has certain curative effects and clinical application value.
文摘BACKGROUND Conventionally, the low luminous intensity, low image resolution, and difficulty in operation have been reported with the ultrathin endoscope. However, it has markedly advanced recently. The improvement of the diagnostic ability is expected.AIM To compare the early gastric cancer diagnostic ability of an ultrathin endoscope loaded with a laser light source and that of the conventional endoscope.METHODS The target subjects were 375 consecutive patients who underwent endoscopy at our hospital for post-endoscopic submucosal dissection follow-up of gastric cancer from January to August 2018. During endoscopy, the ultrathin endoscope was used in 140 patients(37.3%), and the conventional endoscope was used in235 patients(62.7%). Patient background was adjusted using the propensity score matching method, and gastric cancer detection ability was evaluated in the two groups.RESULTS The gastric cancer detection rate was 7.8% in the ultrathin endoscope group and7.0% in the conventional endoscope group, and the mean intragastric observation time was 4.1 ± 1.7 min in the ultrathin endoscope group and 4.1 ± 1.9 min in the conventional endoscope group, showing no significant differences between the groups. Moreover, the biopsy implementation rate was 31.8% in the ultrathin endoscope group and 41.1% in the conventional endoscope group, and the biopsy prediction rate was 17.9% and 13.2%, respectively, showing no significant differences between the groups.CONCLUSION The gastric cancer diagnostic ability of the ultrathin endoscope loaded with a laser light source was comparable to that of the conventional endoscope. The observation time was also comparable. Thus, endoscopy using the ultrathin endoscope loaded with the laser light source would be the first option in screening examinations of gastric cancer due to its low invasion.
基金Project supported by the National High-Tech R&D Program(863)of China(No.2014AA021405)
文摘Objectives： This pilot study of employing chlorine dioxide （CD） gas to disinfect gastrointestinal endoscopes was conducted to meet the expectations of many endoscopy units in China for a high-efficiency and low-cost disin- fectant. Methods： An experimental prototype with an active circulation mode was designed to use CD gas to disinfect gastrointestinal endoscopes. One type of testing device composed of polytetrafluoroethylene （PTFE） tubes （2 m long, inner diameter 1 mm） and bacterial carrier containers was used to simulate the channel of the endoscope. PTFE bacterial carriers inoculated with Bacillus atrophaeus with or without organic burden were used to evaluate the spor- icidal activity of CD gas. Factors including exposure dosage, relative humidity （RH）, and flow rate （FR） influencing the disinfection effect of CD gas were investigated. Moreover, an autoptic disinfecting test on eight real gastrointestinal endoscopes after clinical use was performed using the experimental prototype. Results： IRH, exposure dosage, or- ganic burden, and the FIR through the channel significantly （P〈0.05） affected the disinfection efficacy of CD gas for a long and narrow lumen. The log reduction increased as FR decreased. Treatment with 4 mg/L CD gas for 30 min at 0.8 L/min FR and 75% IRH, resulted in complete inactivation of spores. Furthermore, all eight endoscopes with a maximum colony-forming unit of 915 were completely disinfected. The cost was only 3 CNY （0.46 USD） for each endoscope. Conclusions： The methods and results reported in this study could provide a basis for further studies on using CD gas for the disinfection of endoscopes.
