AIM： To study the prolonged colonic motility under normal conditions with a novel capsule-style microsystem and to assess its clinical significance. METHODS： A single use telemetry capsule （10 mm in diameter, 20 mm...AIM： To study the prolonged colonic motility under normal conditions with a novel capsule-style microsystem and to assess its clinical significance. METHODS： A single use telemetry capsule （10 mm in diameter, 20 mm in length） embedded with a pressure sensor was ingested by the subjects. The sensor is capable of transmitting colonic pressure wirelessly for more than 130 h. The time of capsule entering the segmental colon was detected by ultrasound. The ultrasonic electrodes were mounted on the surface of the ileocecum and navel and at the junction of the left and rectosigmoid colon of the subjects in sequence, which were identified by abdominal X-rays with radiopaque markers. To verify the accuracy and reliability of ultrasonic detection of telemetry capsules at key points of colon, the segmental colonic transit time was simultaneously recorded by using radiopaque markers. RESULTS： The signal lamp showed that all recorders could receive the radio signal transmitted by the telemetry capsule. The X-rays showed that all telemetry capsules were detected successfully when they were passing through the key points of colon. There was a significant correlation between the transit results obtained by ultrasonic detection or by radiopaque markers. Colorectal recording was obtained from 20 healthy subjects during 613 h （411 h during waking, 202 h during sleep）. Compared to waking, the number of pressure contractions and the area under pressure contractions were significantly （P 〈 0.05） decreased during sleep （21 ± 5 h^-vs 15 ± 4 h1, 463 ± 54 mmHg·/min vs 342 ± 45 mmHg·/min）. The colonic motility exhibited significant regional variations both in the circadian behavior and in response to waking and meal. CONCLUSION： The capsule-style micro-system is reliable and noninvasive, and may represent a useful tool for the study of physiology and pathology of colonic motor disorders.展开更多
Background:Extensive ulcerative colitis(UC)causes diffuse colonic inflammation and is often less responsive to conventional therapies.Topical treatments such as rectal enemas have limited proximal reach,reducing effi-...Background:Extensive ulcerative colitis(UC)causes diffuse colonic inflammation and is often less responsive to conventional therapies.Topical treatments such as rectal enemas have limited proximal reach,reducing effi-cacy for pan-colonic disease.Transendoscopic enteral tubing(TET)enables repeated,targeted pan-colonic drug delivery and may enhance the therapeutic effect of traditional Chinese medicine(TCM)enemas.Objective:To evaluate the efficacy and safety of TET-assisted pan-colonic retention enema with Compound Qing-dai compared with conventional rectal enema in patients with active,extensive UC over a 14-day observation period.Methods:18 patients with active,extensive UC(November 2018-September 2021)were randomized 1:1 to a pan-colonic enema group(n=9)or a rectal enema group(n=9).The experimental group received TET enema,and the control group received rectal administration enema.The cut-offpoint of evaluation was 14 days,observe and compare the clinical intestinal symptoms,disease severity,endoscopic scores,mucosal histopathology scores,laboratory indicators and adverse reactions of the two groups.Results:After 14 days,both groups demonstrated significant improvements in clinical symptoms and modified Mayo scores compared to baseline(P<0.05),with greater reduction in the pan-colonic group(P<0.05).The clinical response rates were 100.0%for the pan-colonic group and 66.7%for the rectal group;remission rates were 44.4%and 33.3%,respectively.Regarding the Mayo Endoscopic Subscore(MES),endoscopic mucosal im-provement was significant across all intestinal segments in both groups compared to baseline(P<0.05),with the pan-colonic group exhibiting superior mucosal healing compared to the rectal group(P<0.05).The mucosal healing rate was 77.78%in the pan-colonic group versus 22.22%in the rectal group.Ulcerative Colitis Endo-scopic Index of Severity(UCEIS)scores of both distal and proximal colon improved significantly post-treatment in both groups(P<0.05).Notably,proximal colon improvement was significantly greater in the pan-colonic group(P<0.001).Histopathological analysis revealed a significant decrease in Geboes scores in both groups after treatment(P<0.05),with the pan-colonic group showing superior improvement compared to the rectal group(P<0.05).The blood biochemical indicators,namely Fecal Calprotectin(FC),White Blood Cell(WBC),Platelet count(PLT),Erythrocyte Sedimentation Rate(ESR),C-reactive Protein(CRP),and stool occult blood(OB)score were all decreased after treatment.Moreover,fecal OB score in both groups were significantly decreased(P<0.05),while FC score in pan-colonic colon group was significantly decreased compared with before treatment(P<0.001).Neither group showed significant adverse effects(P>0.05).Conclusion:TET-assisted pan-colonic retention enema with Compound Qingdai achieves superior clinical,en-doscopic,and histological outcomes compared with conventional rectal enema in extensive UC,offering a more effective drug delivery method for achieving better inflammation relief and provides a new way for the treatment of UC with TCM.展开更多
基金Supported by the High Technology Research and Development Program of China, No. 2004AA404013
文摘AIM： To study the prolonged colonic motility under normal conditions with a novel capsule-style microsystem and to assess its clinical significance. METHODS： A single use telemetry capsule （10 mm in diameter, 20 mm in length） embedded with a pressure sensor was ingested by the subjects. The sensor is capable of transmitting colonic pressure wirelessly for more than 130 h. The time of capsule entering the segmental colon was detected by ultrasound. The ultrasonic electrodes were mounted on the surface of the ileocecum and navel and at the junction of the left and rectosigmoid colon of the subjects in sequence, which were identified by abdominal X-rays with radiopaque markers. To verify the accuracy and reliability of ultrasonic detection of telemetry capsules at key points of colon, the segmental colonic transit time was simultaneously recorded by using radiopaque markers. RESULTS： The signal lamp showed that all recorders could receive the radio signal transmitted by the telemetry capsule. The X-rays showed that all telemetry capsules were detected successfully when they were passing through the key points of colon. There was a significant correlation between the transit results obtained by ultrasonic detection or by radiopaque markers. Colorectal recording was obtained from 20 healthy subjects during 613 h （411 h during waking, 202 h during sleep）. Compared to waking, the number of pressure contractions and the area under pressure contractions were significantly （P 〈 0.05） decreased during sleep （21 ± 5 h^-vs 15 ± 4 h1, 463 ± 54 mmHg·/min vs 342 ± 45 mmHg·/min）. The colonic motility exhibited significant regional variations both in the circadian behavior and in response to waking and meal. CONCLUSION： The capsule-style micro-system is reliable and noninvasive, and may represent a useful tool for the study of physiology and pathology of colonic motor disorders.
基金Traditional Chinese Medicine Key Research Funding Project of Zhejiang Province(No.2022ZZ012)Inheritance Studio Project of Famous Traditional Chinese Medicine Expert QIN Dan-ping in Zhejiang Province(No.GZS2020020)。
文摘Background:Extensive ulcerative colitis(UC)causes diffuse colonic inflammation and is often less responsive to conventional therapies.Topical treatments such as rectal enemas have limited proximal reach,reducing effi-cacy for pan-colonic disease.Transendoscopic enteral tubing(TET)enables repeated,targeted pan-colonic drug delivery and may enhance the therapeutic effect of traditional Chinese medicine(TCM)enemas.Objective:To evaluate the efficacy and safety of TET-assisted pan-colonic retention enema with Compound Qing-dai compared with conventional rectal enema in patients with active,extensive UC over a 14-day observation period.Methods:18 patients with active,extensive UC(November 2018-September 2021)were randomized 1:1 to a pan-colonic enema group(n=9)or a rectal enema group(n=9).The experimental group received TET enema,and the control group received rectal administration enema.The cut-offpoint of evaluation was 14 days,observe and compare the clinical intestinal symptoms,disease severity,endoscopic scores,mucosal histopathology scores,laboratory indicators and adverse reactions of the two groups.Results:After 14 days,both groups demonstrated significant improvements in clinical symptoms and modified Mayo scores compared to baseline(P<0.05),with greater reduction in the pan-colonic group(P<0.05).The clinical response rates were 100.0%for the pan-colonic group and 66.7%for the rectal group;remission rates were 44.4%and 33.3%,respectively.Regarding the Mayo Endoscopic Subscore(MES),endoscopic mucosal im-provement was significant across all intestinal segments in both groups compared to baseline(P<0.05),with the pan-colonic group exhibiting superior mucosal healing compared to the rectal group(P<0.05).The mucosal healing rate was 77.78%in the pan-colonic group versus 22.22%in the rectal group.Ulcerative Colitis Endo-scopic Index of Severity(UCEIS)scores of both distal and proximal colon improved significantly post-treatment in both groups(P<0.05).Notably,proximal colon improvement was significantly greater in the pan-colonic group(P<0.001).Histopathological analysis revealed a significant decrease in Geboes scores in both groups after treatment(P<0.05),with the pan-colonic group showing superior improvement compared to the rectal group(P<0.05).The blood biochemical indicators,namely Fecal Calprotectin(FC),White Blood Cell(WBC),Platelet count(PLT),Erythrocyte Sedimentation Rate(ESR),C-reactive Protein(CRP),and stool occult blood(OB)score were all decreased after treatment.Moreover,fecal OB score in both groups were significantly decreased(P<0.05),while FC score in pan-colonic colon group was significantly decreased compared with before treatment(P<0.001).Neither group showed significant adverse effects(P>0.05).Conclusion:TET-assisted pan-colonic retention enema with Compound Qingdai achieves superior clinical,en-doscopic,and histological outcomes compared with conventional rectal enema in extensive UC,offering a more effective drug delivery method for achieving better inflammation relief and provides a new way for the treatment of UC with TCM.
