AIM To evaluate the agreement of multichannel intraluminal impedance-p H monitoring(MII-p HM) and gastroesophageal reflux scintigraphy(GES) for the diagnosis of gastroesophageal reflux disease. METHODS Seventy-five co...AIM To evaluate the agreement of multichannel intraluminal impedance-p H monitoring(MII-p HM) and gastroesophageal reflux scintigraphy(GES) for the diagnosis of gastroesophageal reflux disease. METHODS Seventy-five consecutive patients with suspectedgastroesophageal reflux disease(GERD) underwent 24-h combined MII-p HM recording and one hour radionuclide scintigraphy during the course of the MIIpH M study. Catheters with 6 impedance channels and 1 p H sensor were placed transnasally. Impedance and p H data analysis were performed automatically and manually. For impedance monitoring, reflux was defined as a retrograde 50% drop in impedance, starting distally and propagating retrogradely to at least the next two more proximal measuring channels. Reflux index(RI, percentage of the entire record that esophageal p H is < 4.0) greater than 4.2% for p HM and number of refluxes more than 50 for 24 h for MII were accepted as positive test results. At scintigraphy, 240 frames of 15 seconds duration were acquired in the supine position. Gastroesophageal reflux was defined as at least one reflux episode in the esophagus. After scintigraphic evaluation, impedance-pH recordings and scintigraphic images were evaluated together and agreement between tests were evaluated with Cohen's kappa.RESULTS Sufficient data was obtained from 60(80%) patients(34 male, 56.7%) with a mean age of 8.7 ± 3.7 years(range: 2.5-17.3 years; median: 8.5 years). Chronic cough, nausea, regurgitation and vomiting were the most frequent symptoms. The mean time for recording of MII-pH M was 22.8 ± 2.4 h(range: 16-30 h; median: 22.7 h). At least one test was positive in 57(95%) patients. According to diagnostic criteria, GERD was diagnosed in 34(57.7%), 44(73.3%), 47(78.3%) and 51(85%) patients by means of p HM, MII, GES and MII-p HM, respectively. The observed percentage agreements/κ values for GES and p HM, GES and MII, GES and MII-p HM, and MII and p HM are 48.3%/-0.118; 61.7%/-0.042; 73.3%/0.116 and 60%/0.147, respectively. There was no or slight agreement between GES and p HM alone, MII alone or MII-p HM. p H monitoring alone missed 17 patients compared to combined MII-p HM. The addition of MII to pH monitoring increased the diagnosis rate by 50%.CONCLUSION No or slight agreement was found among p H monitoring, MII monitoring, MII-pH monitoring and GES for the diagnosis of gastroesophageal reflux disease.展开更多
AIM To compare the outcomes between laparoscopic Nissen fundoplication(LNF)and proton pump inhibitors(PPIs)therapy in patients with laryngopharyngeal reflux(LPR)and typeⅠhiatal hernia diagnosed by oropharyngeal p H-m...AIM To compare the outcomes between laparoscopic Nissen fundoplication(LNF)and proton pump inhibitors(PPIs)therapy in patients with laryngopharyngeal reflux(LPR)and typeⅠhiatal hernia diagnosed by oropharyngeal p H-monitoring and symptom-scale assessment.METHODS From February 2014 to January 2015,70 patients who were diagnosed with LPR and type I hiatal hernia and referred for symptomatic assessment,oropharyngeal p H-monitoring,manometry,and gastrointestinal endoscopy were enrolled in this study.All of the patients met the inclusion criteria.All of the patients underwent LNF or PPIs administration,and completed a2-year follow-up.Patients’baseline characteristics and primary outcome measures,including comprehensive and single symptoms of LPR,PPIs independence,and satisfaction,and postoperative complications were assessed.The outcomes of LNF and PPIs therapy were analyzed and compared. RESULTS There were 31 patients in the LNF group and 39patients in the PPI group.Fifty-three patients(25 in the LNF group and 28 in the PPI group)completed reviews and follow-up.Oropharyngeal p H-monitoring parameters were all abnormal with high acid exposure,a large amount of reflux,and a high Ryan score,associated reflux symptom index(RSI)score.There was a significant improvement in the RSI and LPR symptom scores after the 2-year follow-up in both groups(P<0.05),as well as typical symptoms of gastroesophageal reflux disease.Improvement in the RSI(P<0.005)and symptom scores of cough(P=0.032),mucus(P=0.011),and throat clearing(P=0.022)was significantly superior in the LNF group to that in the PPI group.After LNF and PPIs therapy,13 and 53 patients achieved independence from PPIs therapy(LNF:44.0%vs PPI:7.14%,P<0.001)during follow-up,respectively.Patients in the LNF group were more satisfied with their quality of life than those in the PPI group(LNF:62.49±28.68 vs PPI:44.36±32.77,P=0.004).Body mass index was significantly lower in the LNF group than in the PPI group(LNF:22.2±3.1kg/m^2 vs PPI:25.1±2.9 kg/m^2,P=0.001).CONCLUSION Diagnosis of LPR should be assessed with oropharyngeal p H-monitoring,manometry,and the symptom-scale.LNF achieves better improvement than PPIs for LPR with type I hiatal hernia.展开更多
Laboratory experiments were conducted to measure the compressional wave velocities under hydrostatic pressure in Shirahama Tako sandstones with a porosity of 12% and 24%,respectively.In dry samples,the pressure depend...Laboratory experiments were conducted to measure the compressional wave velocities under hydrostatic pressure in Shirahama Tako sandstones with a porosity of 12% and 24%,respectively.In dry samples,the pressure dependence of velocity is ascribed to the difference in pore structures.Velocities were also measured to map the movement of the injected CO2 within water-saturated samples during CO2 injection.In the water-saturated samples,velocity changes caused by the CO2 injection are typically on the order of 10%.A series of seismic tomography experiments are conducted on porous sandstone samples to demonstrate the use of cross-well seismic profiling for monitoring the migration of CO2 in geological sequestration projects.展开更多
This paper focuses on the key technologies of P2P technology and network traffic monitoring, which focuses on AC automaton and bypass interference control technology, and on based of it, we design a new P2P traffic mo...This paper focuses on the key technologies of P2P technology and network traffic monitoring, which focuses on AC automaton and bypass interference control technology, and on based of it, we design a new P2P traffic monitoring system. The system uses DPI and DFI recognition technology, as well as straight loss and bypass interference control technology, basically meet the recognition and control of P2P traffic. Finally, the test results show that this system recognition accuracy of P2P traffic is high, good control effect, function and performance meet the design requirements.展开更多
目的应用24 h pH阻抗监测技术分析胃食管反流性咳嗽(gastroesophageal reflux cough,GERC)患者的反流特点,探讨GERC的发病机制。方法选取慢性咳嗽患者116例,根据24 h pH阻抗监测结果和抗反流治疗结果将符合GERC诊断标准患者定为GERC组,...目的应用24 h pH阻抗监测技术分析胃食管反流性咳嗽(gastroesophageal reflux cough,GERC)患者的反流特点,探讨GERC的发病机制。方法选取慢性咳嗽患者116例,根据24 h pH阻抗监测结果和抗反流治疗结果将符合GERC诊断标准患者定为GERC组,选取健康志愿者30例设为对照组。比较两组pH阻抗联合监测结果。结果根据24 h pH阻抗监测结果和抗反流治疗结果符合GERC诊断标准的患者共有96例,其中28例患者合并弱酸反流异常,12例患者合并弱碱反流异常。GERC组24 h食管pH监测的6项参数及De Meester评分均高于对照组,差异均有统计学意义(P<0.01)。与对照组相比,GERC组24 h食管阻抗监测近端反流次数,气体反流、液体反流及混合反流次数,酸反流、弱酸反流、弱碱反流次数差异均有统计学意义(P<0.01);GERC患者总反流次数、总弱酸反流次数与总弱碱反流次数与SAP呈正相关(P<0.05)。结论 GERC患者存在反流物理性质和酸碱性方面的反流异常,直立位反流较卧位明显。GERC患者存在两种不同类型的发病机制,以低位反流为主,但57.93%的反流物可至食管近端。24 h食管pH阻抗监测是诊断GERC的可靠方法,在临床上具有较好的应用前景。展开更多
基金Supported by the Scientific and Technological Research Council of Turkey,No.106S191-SBAG-3439
文摘AIM To evaluate the agreement of multichannel intraluminal impedance-p H monitoring(MII-p HM) and gastroesophageal reflux scintigraphy(GES) for the diagnosis of gastroesophageal reflux disease. METHODS Seventy-five consecutive patients with suspectedgastroesophageal reflux disease(GERD) underwent 24-h combined MII-p HM recording and one hour radionuclide scintigraphy during the course of the MIIpH M study. Catheters with 6 impedance channels and 1 p H sensor were placed transnasally. Impedance and p H data analysis were performed automatically and manually. For impedance monitoring, reflux was defined as a retrograde 50% drop in impedance, starting distally and propagating retrogradely to at least the next two more proximal measuring channels. Reflux index(RI, percentage of the entire record that esophageal p H is < 4.0) greater than 4.2% for p HM and number of refluxes more than 50 for 24 h for MII were accepted as positive test results. At scintigraphy, 240 frames of 15 seconds duration were acquired in the supine position. Gastroesophageal reflux was defined as at least one reflux episode in the esophagus. After scintigraphic evaluation, impedance-pH recordings and scintigraphic images were evaluated together and agreement between tests were evaluated with Cohen's kappa.RESULTS Sufficient data was obtained from 60(80%) patients(34 male, 56.7%) with a mean age of 8.7 ± 3.7 years(range: 2.5-17.3 years; median: 8.5 years). Chronic cough, nausea, regurgitation and vomiting were the most frequent symptoms. The mean time for recording of MII-pH M was 22.8 ± 2.4 h(range: 16-30 h; median: 22.7 h). At least one test was positive in 57(95%) patients. According to diagnostic criteria, GERD was diagnosed in 34(57.7%), 44(73.3%), 47(78.3%) and 51(85%) patients by means of p HM, MII, GES and MII-p HM, respectively. The observed percentage agreements/κ values for GES and p HM, GES and MII, GES and MII-p HM, and MII and p HM are 48.3%/-0.118; 61.7%/-0.042; 73.3%/0.116 and 60%/0.147, respectively. There was no or slight agreement between GES and p HM alone, MII alone or MII-p HM. p H monitoring alone missed 17 patients compared to combined MII-p HM. The addition of MII to pH monitoring increased the diagnosis rate by 50%.CONCLUSION No or slight agreement was found among p H monitoring, MII monitoring, MII-pH monitoring and GES for the diagnosis of gastroesophageal reflux disease.
文摘AIM To compare the outcomes between laparoscopic Nissen fundoplication(LNF)and proton pump inhibitors(PPIs)therapy in patients with laryngopharyngeal reflux(LPR)and typeⅠhiatal hernia diagnosed by oropharyngeal p H-monitoring and symptom-scale assessment.METHODS From February 2014 to January 2015,70 patients who were diagnosed with LPR and type I hiatal hernia and referred for symptomatic assessment,oropharyngeal p H-monitoring,manometry,and gastrointestinal endoscopy were enrolled in this study.All of the patients met the inclusion criteria.All of the patients underwent LNF or PPIs administration,and completed a2-year follow-up.Patients’baseline characteristics and primary outcome measures,including comprehensive and single symptoms of LPR,PPIs independence,and satisfaction,and postoperative complications were assessed.The outcomes of LNF and PPIs therapy were analyzed and compared. RESULTS There were 31 patients in the LNF group and 39patients in the PPI group.Fifty-three patients(25 in the LNF group and 28 in the PPI group)completed reviews and follow-up.Oropharyngeal p H-monitoring parameters were all abnormal with high acid exposure,a large amount of reflux,and a high Ryan score,associated reflux symptom index(RSI)score.There was a significant improvement in the RSI and LPR symptom scores after the 2-year follow-up in both groups(P<0.05),as well as typical symptoms of gastroesophageal reflux disease.Improvement in the RSI(P<0.005)and symptom scores of cough(P=0.032),mucus(P=0.011),and throat clearing(P=0.022)was significantly superior in the LNF group to that in the PPI group.After LNF and PPIs therapy,13 and 53 patients achieved independence from PPIs therapy(LNF:44.0%vs PPI:7.14%,P<0.001)during follow-up,respectively.Patients in the LNF group were more satisfied with their quality of life than those in the PPI group(LNF:62.49±28.68 vs PPI:44.36±32.77,P=0.004).Body mass index was significantly lower in the LNF group than in the PPI group(LNF:22.2±3.1kg/m^2 vs PPI:25.1±2.9 kg/m^2,P=0.001).CONCLUSION Diagnosis of LPR should be assessed with oropharyngeal p H-monitoring,manometry,and the symptom-scale.LNF achieves better improvement than PPIs for LPR with type I hiatal hernia.
文摘Laboratory experiments were conducted to measure the compressional wave velocities under hydrostatic pressure in Shirahama Tako sandstones with a porosity of 12% and 24%,respectively.In dry samples,the pressure dependence of velocity is ascribed to the difference in pore structures.Velocities were also measured to map the movement of the injected CO2 within water-saturated samples during CO2 injection.In the water-saturated samples,velocity changes caused by the CO2 injection are typically on the order of 10%.A series of seismic tomography experiments are conducted on porous sandstone samples to demonstrate the use of cross-well seismic profiling for monitoring the migration of CO2 in geological sequestration projects.
文摘This paper focuses on the key technologies of P2P technology and network traffic monitoring, which focuses on AC automaton and bypass interference control technology, and on based of it, we design a new P2P traffic monitoring system. The system uses DPI and DFI recognition technology, as well as straight loss and bypass interference control technology, basically meet the recognition and control of P2P traffic. Finally, the test results show that this system recognition accuracy of P2P traffic is high, good control effect, function and performance meet the design requirements.
文摘目的应用24 h pH阻抗监测技术分析胃食管反流性咳嗽(gastroesophageal reflux cough,GERC)患者的反流特点,探讨GERC的发病机制。方法选取慢性咳嗽患者116例,根据24 h pH阻抗监测结果和抗反流治疗结果将符合GERC诊断标准患者定为GERC组,选取健康志愿者30例设为对照组。比较两组pH阻抗联合监测结果。结果根据24 h pH阻抗监测结果和抗反流治疗结果符合GERC诊断标准的患者共有96例,其中28例患者合并弱酸反流异常,12例患者合并弱碱反流异常。GERC组24 h食管pH监测的6项参数及De Meester评分均高于对照组,差异均有统计学意义(P<0.01)。与对照组相比,GERC组24 h食管阻抗监测近端反流次数,气体反流、液体反流及混合反流次数,酸反流、弱酸反流、弱碱反流次数差异均有统计学意义(P<0.01);GERC患者总反流次数、总弱酸反流次数与总弱碱反流次数与SAP呈正相关(P<0.05)。结论 GERC患者存在反流物理性质和酸碱性方面的反流异常,直立位反流较卧位明显。GERC患者存在两种不同类型的发病机制,以低位反流为主,但57.93%的反流物可至食管近端。24 h食管pH阻抗监测是诊断GERC的可靠方法,在临床上具有较好的应用前景。
