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Objective To study the effect of squatting toilet behavior on gastric transport time (GTT) and complete examination rate of small bowel (CER) during capsule endoscopy. Methods A total of 122 patients who underwent capsule endoscopy at the Second Affiliated Hospital of Chongqing Medical University from January to December 2019 were recruited and randomly divided into test group (n=63) and control group (n=59). The patients of the test group were asked to take squatting posture for toileting after swallowing the capsule, while those of the control group were asked to take sitting in defecation if needed. GTT, small bowel transit time (SBTT), CER and diagnostic yield (DY) were compared between the 2 groups. Results There were no significant differences in gender, age and conditions during hospitalization between the test group and the control group. The test group obtained obviously higher CER (92.06% vs 79.66%, P=0.048) and shorter GTT (26.7 vs 45.6 min, P=0.027) when compared with the control group. No statistical differences were seen in SBTT and DY between the 2 groups. Conclusion Squatting posture for toileting of patients accepted capsule endoscopy can reduce the transit time of capsules in the stomach and increase the CER.

Copyright of Chinese Medical Equipment Journal is the property of Chinese Medical Equipment Journal Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To evaluate the clinical value of capsule endoscope in the diagnosis of unexplained abdominal pain. Methods We made a retrospective analysis of 191 patients with unexplained abdominal pain who sought medical help in our hospital and 25 normal controls. Capsule endoscopy was performed in both groups, small bowel lesions were detected, and clinical data were collected for further analysis. Results The total small bowel lesion detection rate was 52.87% (101/191) in abdominal pain (AP) patients and 20% (5/25) in the control group, respectively. The detection rate of significant findings (ulcers, erosions, polyps, diverticula, parasites, and neoplastic organisms) was only 16.23% (31/191) in AP patients. In the non-significant findings, no statistical difference in the detection rates for vascular malformation, capillary dilation, and lymphoid follicular hyperplasia were found between the two groups, while the detection rate of intestinal lymphangiectasia was significantly higher in the AP patients (23.56% vs. 4%, P＜0.05, OR=7.089). Conclusion Capsule endoscopy can be an optional choice for diagnosis of unexplained abdominal pain, while the relationship between positive findings and abdominal pain should be further investigated. [ABSTRACT FROM AUTHOR]

Suspected small bowel bleeding (SSBB) is called obscure gastrointestinal bleeding (OGIB) in the early stage, and it is defined as obscure overt or occult bleeding, which persists or recurs after the initial negative two-way endoscopic examination, including colonoscopy and gastroscopy, accounting for about 5%～10% of gastrointestinal bleeding. With the development of small bowel imaging techniques, including video capsule endoscopy (VCE),angiography and device-assisted enteroscopy (DAE),most patients with obscure gastrointestinal bleeding can recognize bleeding from the small bowel. Therefore, the American College of Gastroenterology (ACG) and American Gastrointestinal Endoscopy Guidelines (ASGE) point out that after gastroscopy and colonoscopy are negative, it is appropriate to use SSBB instead of OGIB. However, because of the particularity of the physiological structure of the small bowel, it was once called "the human black box", so the diagnosis and treatment of SSBB is still a challenge for gastroenterologists. Therefore, this paper systematically reviews the diagnosis methods of SSBB,in order to provide reference for clinical practice. [ABSTRACT FROM AUTHOR]

Objective To assess the effects of dimethicone at different doses in bowel preparation for small bowel capsule endoscopy (SBCE) and explore the optimal dose for the examination. Methods A multicenter randomized controlled trial (RCT) was carried out on 132 patients from 4 different institutions from May 2016 to January 2019. They were randomly divided into 3 groups, with 44 cases in each group. All of them were given 2 liters of polyethylene glycol (PEG) solution orally 6 h before procedure, and then in 30 min before examination, the patients were asked to drink 100 mL pure water, 2.5 g and 5 g 100 mL dimethicone solution for those from group A, B and C, respectively. The primary evaluation indexes included small bowel bubble quantity (SBBQ), small bowel valid picture ratio (SBVPR), small bowel cleaning quality (SBCQ), and the secondary evaluation indexes contained gastric bubble quantity (GBQ), gastric cleaning quality (GCQ), completion rate (CR), diagnostic yield (DY), and small bowel transit time (SBTT) and gastric transit time(GTT) of the capsule. Results The SBBQ of group A was higher than those of the other 2 groups in the proximal, middle and distal segments of small intestine (P0.05). Similar results were seen in the SBIRP in the 3 groups. No statistical significances were found in other indexes among the 3 groups (P>0.05). Conclusion Dimethicone treatment can efficiently decrease intraluminal bubbles and improve the visibility of small bowel mucosa for SBCE, and the optimal dose of dimethicone is 2.5 g.

Objective To establish an index evaluation system for evaluating the comprehensive clinical applications of capsule endoscopy and determine the weight of each indicator, and then utilize the evaluation system to comparatively analyze the domestic and imported capsule endoscopy in order to provide scientific basis for the applications including technology, clinic and market performance of the capsule endoscopy eventually. Methods The framework of evaluation system was preliminarily formulated through literature analysis and expert consultation, and the 3-level indicators and weight of them in capsule endoscopic evaluation were determined by Delphi method and analytic hierarchy process (AHP). Factor analysis was employed to empirically analyze the evaluation indexes of domestic and imported capsule endoscopes. Results The response rates of the 2 questionnaires were 93.3% (28/30) and 96.4% (27/28), respectively; the average authoritative coefficients of the experts were 0.867 and 0.858, respectively. The Kendall (Kendall) coordination coefficients of the 3-level indicators in the 2 questionnaires were 0.324, 0.189 and 0.140, and 0.280, 0.192 and 0.124, respectively (P < 0.01, by Chi-square test), with certain consistency. At last, we determined 3 indicators of primary indexes, 10 indicators of secondary indexes, and 41 indicators of tertiary indexes, and the weights of each indicator, among which the weights of first-level indicator for technology, clinic and market performance were 0.349 0, 0.437 4 and 0.213 6, respectively. Analysis of technical indicators showed that the domestic capsule endoscope had significantly smaller size (P < 0.01), obviously larger weight (P < 0.01), but remarkably lower resolution (P < 0.05) when compared with the imported one. In the evaluation of clinical performance indexes, the domestic capsule endoscope had significantly longer image processing time (P < 0.01), obviously lower picture resolution (P < 0.01), but markedly better portability and comfortableness of the recorder (P < 0.01) than the imported one. In terms of market performance, the price of domestic capsule endoscope was distinctly lower than that of imported capsule endoscopy (P < 0.01). Conclusion Our obtained 3-level indexes by experts are concentrated, consistent and credible. The capsule endoscopic evaluation index system constructed by Delphi and AHP is scientific, reasonable and practical. And the practical comparative analysis can further provide an objective and quantifiable basis for the research of clinical evaluations.

Objectives: To explore the value of different endoscopic scoring methods in assessing disease activity in pediatric Crohn's disease (CD)., Methods: A total of 70 children diagnosed with CD at the Children's Hospital of Chongqing Medical University from January 2018 to January 2023 were included. Clinical disease activity was assessed using the Pediatric Crohn's Disease Activity Index (PCDAI), while different endoscopic scores were assigned based on endoscopic findings. Spearman rank correlation analysis was used to evaluate the correlation between each endoscopic scoring method and PCDAI as well as laboratory indicators. Kappa test was used to assess the consistency between colonoscopy/capsule endoscopy scoring methods and PCDAI in determining CD activity. Receiver operating characteristic curve analysis was performed to assess the diagnostic efficacy of laboratory indicators in predicting endoscopic activity., Results: The PCDAI score showed a moderate positive correlation with the scores of Crohn's Disease Endoscopic Index of Severity (CDEIS) ( r s =0.696, P <0.01), Simple Endoscopic Score for Crohn's Disease (SES-CD) ( r s =0.680, P <0.01), and Capsule Endoscopy-Crohn's Disease Index (CE-CD) ( r s =0.540, P <0.01), and Capsule Endoscopy-Crohn's Disease Index (CE-CD) ( r s =0.502, P <0.01). The consistency between all endoscopic scoring methods and PCDAI in determining CD activity was poor (Kappa=0.069-0.226). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), hematocrit (HCT), and serum albumin (ALB) levels showed a moderate correlation with the PCDAI score and the scores of colonoscopy scoring methods (CDEIS and SES-CD) (| r s |=0.581-0.725, P <0.01), but a weak correlation with the scores of capsule scoring methods ( P <0.05). ESR and CRP had higher area under the curve (AUC) values in predicting disease activity based on PCDAI, CDEIS, SES-CD, and Lewis Score compared to HCT and ALB ( P <0.05)., Conclusions: CDEIS, SES-CD, Lewis Score, and CE-CD can be used to evaluate disease activity in pediatric CD, but they do not fully correspond with disease activity assessed by PCDAI. Elevated levels of ESR and CRP can predict clinical and endoscopic disease activity in children with CD.

OBJECTIVE: To systematically evaluate the application effect of simethicone combined with polyethylene glycol electrolyte powder for intestinal preparation before capsule endoscopy. METHODS: Pub Med,EMBase,Ovid,the Cochrane Library,Web of Science,Wanfang database,CNKI,CBM and VIP database were retrieved to collect the randomized controlled trial or clinical controlled study of simethicone combined with polyethylene glycol electrolyte powder for intestinal preparation before capsule endoscopy (the study group was given simethicone combined with polyethylene glycol electrolyte powder for intestinal cleaning,the control group was treated with polyethylene glycol electrolyte powder for intestinal cleaning) .The retrieval time was from the establishment of the database to Dec.2019.Rev Man 5. 3 software was used for Meta-analysis.RESULTS: Eleven studies were included in this study,including 9 randomized controlled trials and 2 clinical controlled trials.A total of 1 198 patients were enrolled,with 598 patients in the study group and 600 patients in the control group. Meta-analysis results showed that intestinal bubble volume in the study group was less than that in the control group,and the proportion of patients with grade A intestinal bubble volume in the study group was significantly higher than that in the control group,the difference was statistically significant (OR = 3. 37,95%CI = 1. 96-5. 78,P ＜ 0. 000 01) . The intestinal cleaning in the study group was significantly better than that in the control group,and the proportion of patients with intestinal cleaning level 1 in the study group was significantly higher than that in the control group,the difference was statistically significant (OR =1. 48,95% CI = 1. 06-2. 08,P = 0. 02) . The gastric passage time of capsule endoscopy in the study group was significantly longer than that in the control group,and the difference was statistically significant (MD = 3. 02,95%CI =0. 74-5. 30,P = 0. 009) . There was no significant difference in the passage time of small intestine through capsule endoscopy between two groups (P = 0. 57) . CONCLUSIONS: Simethicone can reduce the amount of bubbles in the intestinal tract and may improve the cleaning of intestinal tract,yet it does not increase the passage time of small intestine through the capsule endoscopy. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To explore the application of MiroCam@capsule endoscopy (CE) in the examination of unexplained gastrointestinal bleeding (OGIB) at different ages.Methods The clinical data of OGIB patients in the Department of Gastroenterology of the Three Gorges University People's Hospital from September 2015 to February 2019 were retrospectively analyzed.All 120 patients underwent CE and mesenteric artery selective digital subtraction angiography (DSA).Grouped according to age:the elderly group (n=52), the young and middle-aged group (n=48) and the minor group (n=20), observing the compliance, safety, complications and pathological examination of the CE examination in the three groups. The results of CE diagnosis to OGIB and the final clinical diagnosis were compared. Results The three groups of patients had no difficulty swallowing capsules. The elderly group and the middle-aged group each had 1 case of CE to enter the small intestine. The ileocecal valve time in the minor group was significantly shorter than that in the elderly group and the middle-aged and younger groups. The discharge time of CE after the operation of the digestive tract in the elderly group was significantly longer than that in the middle-aged group and minor group. All patients were well tolerated during the examination, and there was only one complication of ascending colon retention in the elderly group. There were many adverse reactions such as blood pressure drop, urine retention, pain at the puncture point or a small amount of bleeding during the DSA examination. In the detection rate of CE for OGIB, the elderly group (96.15%) was significantly higher than the other two groups. The overall detection rate of CE for OGIB was 80.83%, and the detection rate of DSA was 23.33%, Comparing the two groups, the difference was statistically significant (P <0.05). The positive rate was 54.17%, the suspected rate was 26.67%, the detected rate was 80.83% and the negative rate was 9.17% of CE examination. Detection sensitivity was 94.85%, specificity was 63.63%, positive predictive value was 97.87%, negative predictive value was 77.78%. Conclusion CE has high stability and safety, few complications, rapid diagnosis, and the entire examination process is simple and easy, which has the value of clinical application and promotion. [ABSTRACT FROM AUTHOR]

Objective To evaluate the diagnostic value and safety of capsule endoscopy in small intestinal diseases．Methods Clinical data of 426 patients with suspected small intestinal diseases in the Department of Gastroenterology of the First Affiliated Hospital of Kunming Medical University from January 2014 to December 2018 which had undergone capsule endoscopy were retrospectively collected and analyzed. Results 426 patients were mainly hospitalized (65.96%). One case(0.23%) failed to complete the examination due to poor intestinal preparation，and 12 cases (2.82%) remained in the gastric cavity and were guided to the small intestine by gastroscopy. One case(0.23%) had capsule retention and was transferred to surgery. The success rate of total small intestinal examination was 99.53%， and the detection rate of small intestinal diseases was 60.56%. Non-specific inflammation accounted for 35.44%of the detected small intestinal lesions. The detection rates of abdominal pain and small intestinal bleeding were significantly higher than those of other patients (P<0.05) ．Conclusion Capsule endoscopy is a safe and effective method for the examination of small intestinal diseases， especially for the diagnosis of abdominal pain and small intestinal bleeding. [ABSTRACT FROM AUTHOR]

In order to locate the capsule endoscope accurately, a high-accuracy 5-dimensional magnetic location technique is proposed. By adding a thin axial magnetic ring to the capsule endoscope shell as the excitation source, the magnetic ring is approximated as a magnetic dipole, and the magnetic field is measured by a magnetic field sensor array around the body, and the location of the capsule and the direction of the lens are solved by the Levenberg-Marquardt algorithm, and the precise positioning of the capsule endoscope is realized. The 5-dimensional magnetic positioning simulation system is developed, and the space posture information of the magnet is displayed in 3-dimensional animation. The experiment shows that according to the location results after calibration, the positioning accuracy and orientation accuracy have been significantly improved, and the precise location and tracking effect are well achieved. [ABSTRACT FROM AUTHOR]

Objective: To investigate the diagnostic value of the single-balloon enteroscopy (SBE) and capsule endoscopy (CE) for obscure gastrointestinal bleeding (OGIB). Methods: According to different diagnostic methods,100 patients with OGIB were divided into SBE group and CE group, 50 patients each group. The lesion detection rate, diagnosis rate and safety were compared between two groups. Results: The etiology diagnosis rate of SBE group was 78 %, and the etiological diagnosis rate of group CE was 60 %, and there was no significant difference between the two groups (P>0.05). The detection rate of lesions in group SBE was 80% (40/50), the detection rate of CE group was 86 %(43/50), and there was no significant difference between the two groups (P>0.05). The examination for the patients in SBE group was more smoothly, while the capsule retention rate in CE group was 4.0%. No patients experienced adverse reactions and complications after inspection. Conclusions: The polyps, mucosal erosion and ulcer disease in OGIB patients is very common by SBE and CE inspection methods, and the detection rate of lesion is equivalent and reliable in two methods and CE examination is more convenient. [ABSTRACT FROM AUTHOR]

Objective To study the effect of different position on the application of capsule endoscopy through the pylorus into duodenum in gastroptosis patients. Methods Sixty gastroptosis patients who accepted OMOM capsule endoscopy from December 2007 to July 2014 were enrolled in this study. The enrolled patients were randomly divided into two groups: right lateral position group (n=30) and control group (n=30). The patients in the control group were allowed to keep upright or sitting position. The patients in the right lateral position group were instructed to lie on right side. Gastric transit time (GTT) were recorded in each patient. Results All 60 patients completed the examination and the success rate was 100% . No patients had capsule retention in the stomach. Gastric transit time in the right position group was significantly shorter than that in the control group (<0.05). Gastric transit time of moderate or severe gastroptosis patients in the right position group was significantly shorter than that of control group (<0.05). There was no significantly difference between mild gastroptosis patients of the two groups (>0.05). Conclusions The right lateral position for the gastroptosis patients can shorten gastric transit time and increase the complete examination rate of the samall bowel. For moderate or severe gastroptosis patients to shorten the transit times of CE, the right side should be taken as early as possible in order to improve the success rate of small bowel examination. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the value of capsule endoscopy in children with small intestinal diseases with hematochezia as the chief complaint., Methods: A retrospective analysis was performed on the clinical data and capsule endoscopy findings of 93 children with hematochezia who were admitted to Children's Hospital of Fudan University from May 2015 to January 2019 and underwent capsule endoscopy. According to the capsule endoscopy findings of the jejunum and the ileum, they were divided into a positive lesion group with 39 patients and a negative lesion group with 54 patients. Related clinical data and the features of lesion on capsule endoscopy were analyzed for the two groups., Results: There were no significant differences in age, sex, duration of capsule endoscopy, gastric transit time, and small intestinal transit time between the positive lesion and negative lesion groups (P>0.05). The positive lesion group had a significantly lower level of hemoglobin than the negative lesion group (P<0.05). Hemoglobin level was negatively correlated with the rate of positive lesions on capsule endoscopy (r=-0.342, P=0.001). Among the 39 patients with positive lesions on capsule endoscopy, the detection of Meckel's diverticulum was the highest (41%), followed by inflammatory bowel disease (21%)., Conclusions: Capsule endoscopy has a certain value in detecting small intestinal diseases, especially diseases in the jejunum and the ileum, in children with lower gastrointestinal hemorrhage.

Objective: To analyze the clinical value of capsule endoscopy (CE) in small intestinal diseases and to explore the correlation between the diagnosis and clinical characteristics. Methods: From June 2016 to April 2019, a total of 194 patients receiving CE were enrolled in the Department of Gastroenterology, Shanxi People's Hospital, including 68 patients with obscure gastrointestinal bleeding, 104 with chronic abdominal pain and 22 with diarrhea. Results: The detection rate of small intestinal lesions by CE was 53.6%(104/194), of which gastrointestinal bleeding was 66.2% (45/68), chronic abdominal pain was 53.8%(56/104), and diarrhea was 13.6%(3/22). The first three positive diagnostic criteria of CE for gastrointestinal bleeding were non-specific inflammation, small intestinal ulcer and vascular malformation. CE findings in patients with abdominal pain were non-specific inflammation, small intestinal ulcer and Crohn's disease; while the major endoscopic presentations in patients with diarrhea were small intestinal ulcer and non-specific inflammation. Logistic regression analysis suggested that the clinical manifestations and gender were correlated with positive diagnosis by CE ( P< 0.05), and the positive diagnostic rate of CE in female patients was significantly lower than that in male patients [31.6%(25/79) vs. 51.3%(59/115), P< 0.05]. The diagnostic rates of CE in patients with gastrointestinal bleeding and chronic abdominal pain were similar [55.9%(38/68) vs. 41.4%(43/104)], which was significantly higher than those with diarrhea [9.1%(2/22), P< 0.05]. Conclusions: Capsule endoscopy has a high detection rate for small intestinal diseases, which could be the first choice in patients with unexplained gastrointestinal bleeding. Male patients and gastrointestinal bleeding are predictors of positive findings by CE.

Since the original version of "Chinese guideline regarding bowel preparation for gastrointestinal endoscopy" was published in 2013, bowel preparation has been widely investigated around the world. In order to improve the quality of bowel preparation, this guideline is an official statement issued by Digestive Endoscopy Special Committee of Endoscopic Physicians Branch of Chinese Medical Association and Cancer Endoscopy Committee of China Anti-Cancer Association. Domestic special experts were invited to search and grade the relevant literature published. An expert seminar was held, in which experts discussed and identified the recommendations, assessed the power of recommendations and the quality of evidence using the "grading of recommendations assessment, development and evaluation (GRADE)" system. The guideline offers practical recommendations for endoscopists regarding the whole procedure of bowel preparation including aims and requirements, preoperative education, diet restriction, the options of intestinal cleansing agents, antifoaming agents, contraindications, preparation for specific patients, and bowel preparation for enteroscopy and capsule endoscopy.

Objective: To evaluate the diagnostic value of capsular endoscopy in patients with obscure gastrointestinal bleeding (OGIB) in different age groups, and assess its effectiveness and safety. Methods: A total of 216 patients who were diagnosed with OGIB between March 2005 and March 2016 at Department of Gastroenterology of Peking Union Medical College Hospital were retrospectively reviewed. They were assigned into three groups: young adults, middle-aged and elderly. The demographic characteristics, clinical manifestations, working performance as well as endoscopic features in each group were collected and analyzed. Results: The detection rate and diagnosis rate of the young adults and middle-aged group were 98.53% vs 98.51% ( P =0.992), 92.65% vs 91.04% ( P =0.734), while those between the young adults and the elderly group were 98.53% vs 91.14% ( P =0.109), 92.65% vs 87.34% ( P =0.289), and 98.51% vs 91.14% ( P =0.113) and 91.04% vs 87.34 ( P =0.475) between the middle-aged and elderly group. No significant difference existed in either detection rates nor diagnostic rates between the different age groups. The distribution of the small intestinal lesions varied between the different age groups. The top three common lesions in young adults were vascular malformation, small intestine ulcer and Crohn's disease, while in the middle-aged group vascular malformation, non-specific enteritis and small intestine ulcer were the most common. Patients in elderly group were most likely to have vascular malformation, small intestine ulcer and erosion. Conclusions: For patients of any age with OGIB, capsule endoscopy is a safe, effective and comfortable examination which can be widely used in clinical practice.

Primary malignant small bowel tumor as a rare kind of intestinal tumor is associated with a poor prognosis. The pathological types were various and complicated, such as adenocarcinoma, neuroendocrine tumor, malignant lymphoma, and malignant stromal tumor. The atypical early stage symptom resulted in difficult diagnosis at early stage, high misdiagnosis rate and lack of standard therapy schemes and means. In the past, X-ray, CT, MRI, and PET-CT were the main examination methods for primary small bowel tumor. However, with the development of radiology, a series of new diagnosis methods, including electronic enteroscopy, capsule endoscopy, multi-slice spiral CT enteroclysis and so on, promotes the diagnosis accurate rate. Surgery is still the most important method in the small bowel tumor treatment, and the alternative of the surgical method should depend on the tumor location, size and relationship with the adjacent organs. Application of the laparoscopic surgery for the small bowel tumor is still in the initial stage. Besides, some researches have confirmed that chemotherapy, radiotherapy, target therapy and endocrinotherapy have effects on the specific kind of small bowel tumor. Therefore this article will review the epidemiology, pathology, diagnosis and treatment of the primary malignant small bowel tumors.

Behcet's disease (BD) is a chronic vascular inflammatory disease of unknown causes. It is called intestinal BD, when digestive tract is involved. To investigate small bowel feature of intestinal BD, we now report 5 intestinal BD cases undergone capsule endoscopy from December, 2010 to April, 2014 in Peking University People's Hospital. General information, clinical feature and endoscopic feature were presented, and literatures were reviewed. There were 3 male and 2 female patients. Age range was from 23 to 55 years old (median age 40 years old). Disease course was from 3 days to 28 years (median course 9 years). 4 patients were diagnosed as systemic BD, and the rest independent intestinal BD. 4 systemic BD patients all presented as recurrent oral aphthous as initial symptom and had history of vulvar ulcer and skin lesion. They all had gastrointestinal symptoms, including retrosternal pain (2 cases), hematochezia (3 cases), diarrhea (3 cases) and abdominal pain (2 cases). 1 patient had a history of fistula of ileocecal junction and underwent caecectomy. 5 patients all underwent whole digestive tract examination by endoscopy, including gastroscopy, colonoscopy and capsule endoscopy.Except of 1 normal result of colonoscopy, all endoscopy results revealed lesions. Capsule endoscopy results of all patients were abnormal. Types of small intestinal lesion were various, including ulceration, erosion, protrusion and vasculopathy. All digestive tract can be involved in BD patients. Capsule endoscopy can evaluate lesions throughout whole digestive tract, especially in small intestine. As a consequence, it is helpful to explain gastrointestinal symptom, increase early diagnostic rate. Intestinal BD (IBD) mainly involves small bowel, and ileum is the major involved segment, not only limited in ileocecum. The updated perspective of IBD lesion distribution will contribute to differential diagnosis between IBD and Crohn's disease.This is the first time to report capsule endoscopic feature of BD patients in China.

Objective: To investigate the frequency of and risk factors for re-bleeding in obscure gastrointestinal bleeding (OGIB) patients who had negative findings in capsule endoscopy (CE)., Methods: Patients with OGIB referred for CE to the First Affiliated Hospital of Zhengzhou University between January 2011 and December 2012 were identified.Follow-up data were obtained via medical records review, telephone interviews or follow-up clinic visits in order to establish the rate of re-bleeding and identify the risk factors associated with re-bleeding among patients with negative CE findings., Results: A total of 198 patients were included in this study, of whom 196 patients completed the follow-up, with a mean (±SD) follow-up of (16.1±5.3) months. In the 196 patients, 94 had negative CE findings and did not receive any further specific treatment for OGIB. Re-bleeding episodes were observed in 32 of the 94 patients (34.0%), and the cumulative re-bleeding rates at 6, 12, 18, and 24 months in follow-up were 3.2%, 6.4%, 20.2%, 34.0%, respectively. There was no statistically significant difference in re-bleeding rate between patients with positive CE findings and patients with negative CE findings (23.7% vs 34.0%, P=0.246). Diabetes mellitus (HR=3.250, 95%CI: 1.296-8.154, P=0.012), minimum hemoglobin levels ≤80 g/L before CE (HR=0.397, 95%CI: 0.172-0.917, P=0.031), and continued use of aspirin after CE (HR=4.915, 95%CI: 1.887-12.800, P=0.001) were independent risk factors for re-bleeding among OGIB patients with negative CE findings., Conclusions: Considering the high risk of re-bleeding, close follow-ups are needed for OGIB patients with negative CE findings.Repeated CE or other investigations (enteroscopy and CT enterography) within 12-24 months are recommended for the OGIB patients with negative findings in initial CE investigation who have risk factors for re-bleeding.

Objective: To explore the value of magnetic resonance enterography (MRE) for diagnosis of small intestinal diseases in children., Method: A total of 92 children who received MRE from July 2009 to January 2014 were included into this study. The clinical value of MRE in children was evaluated by describing the image presentation of MRE based on clinical diagnosis., Result: All the 92 cases (average age was nine year and one month, among whom 61 were boys, and 31 were girls) received MRE examination with good tolerance and had no complications. Eleven cases (12%) did not show good distension of small bowel loop during MRE and could not evaluate the bowel wall pathologies correctly. A total of 66 cases (72%) showed pathological MRE images. All patients with Crohn's disease showed pathological gut and 53% (16/30) showed extramural changes with MRE, 97% (29/30) showed colon lesions with colonoscopy, 73% (20/22) showed small intestine lesions with capsule endoscopy. All patients with intestinal obstruction (7 cases) showed abnormal gut distension, 4 of whom showed obstruction point. Five patients with small intestinal neoplasms showed the mass with MRE. One of the patients with intestinal tuberculosis showed enlarged lymph nodes with ring strengthening. Nine cases with eosinophilic gastroenteritis (75%) and 1 case of gastrointestinal bleeding showed increased contrast enhancement for small bowel. The main finding of MRE were abnormal wall thickening and enhancement, gut stricture, bowel expansion, etc., Conclusion: MRE for children was safe and reliable. It can be a suitable method for determining the location and extent of gut for small intestinal diseases, especially suitable for Crohn's disease in children.

Objective: To evaluate the diagnostic value of magnetic resonance enterography (MRE) for small intestinal disease., Methods: From January to July 2013, 53 consecutive patients(male/female = 22/31, median age = 61 years) with suspected small intestinal disease were recruited. And the examinations of MRE and capsule endoscopy (CE) examinations were performed., Results: MRE revealed 31 cases (31/53) and CE 30 cases (30/45) of small intestinal diseases. Receiver operating characteristic (ROC) curve revealed that the area under the curve (AUC) of MRE was 90% in detecting small intestine lesions and AUC of MRE was 72. 9% in diagnosing small intestine lesions. There was a remarkable coherence of MRE and CE in detecting small intestine lesions (χ2 = 28. 800, P = 0. 000)., Conclusion: MRE is ideal for detecting and diagnosing small bowel disease.

Because the huge number of images of the digestive tract by Wireless Capsule Endoscopy (WCE) are left to the medical personnels detected by their eyes, huge burden leaves to doctors. This article provides a classification of method based on SVM (Support Vector Machine) for the capsule endoscopy bleeding intelligent recognition. We created a new kind of feature parameter, and the experiment result can reach 83% specificity and 94% sensitivity.

The clinical data and capsule endoscopy image of 16 adult patients with small intestine ascariasis were reviewed and analyzed retrospectively from June 2006 to June 2012 in West China Hospital. Among the 16 patients, 15 cases manifested as gastrointestinal bleeding, 15 cases showed anemia (3 severe, 10 moderate, and 2 mild), 2 had hypoalbuminemia, 1 had peripheral blood eosinophilia. All the cases were found to be fecal occult blood positive, but no Ascaris eggs found in the feces. Capsule endoscopy showed they were infected with Ascaris worms. The worms were found in the proximal small intestine in 14 patients and 2 in the distal intestine. Mucosal erythema and erosions around the worm were observed in 3 cases, and 7 cases were found with active bleeding or old haemorrhage in small intestine.

Objective: To demonstrate the diagnostic value of capsule endoscopy for small intestine hookworm disease., Methods: A retrospective study was carried out to analyze the clinical data and capsule endoscope image of 55 patients with small intestine hookworm disease in the hospital from June 2006 to June 2012., Results: Among these patients, 40 cases manifested as gastrointestinal bleeding, 7 had iron deficiency anemia, 6 had chronic abdominal pain, and 2 showed abdominal distension or discomfort. Hookworm eggs were found in stool specimens of 2 cases, 6 cases showed peripheral eosinophilia, 46 cases were found to be fecal occult blood positive. Out of the 55 cases investigated, 44 showed anemia (11 severe, 26 moderate, and 7 mild). All patients were definitely diagnosed by capsule endoscopy. The hookworms were translucent and about 5-10 mm in length. Hookworms in most cases were diffusely distributed, but 12 patients suffered massive and severe hookworm infection. In most cases, hookworms were found in the proximal small intestine, and 6 in the distal intestine. Erosion and injury in intestinal mucosa around the hookworm were observed in several cases., Conclusion: Capsule endoscopy is an effective and safe diagnostic technique for hookworm disease in small intestine.

Objective: To investigate the effect of metoclopramide on capsule endoscopy (CE) examination., Methods: Total 116 patients referred for CE were randomized into two groups with 58 patients in each group. In treatment group patients received 10 mg metoclopramide intramuscular injection after swallowing the capsule and in control group no metoclopramide was administered. The gastric transit time, small bowel transit time, complete endoscopy rate were observed in both groups., Results: The CE examination was completed in 51 patients of treatment group (87.9%) and 48 of control group (84.2%). Mean gastric transit time was (32.45 ± 29.63) min in treatment group and (45.81 ± 40.01)min in control group, there was significant difference between two groups (P<0.05). Mean small bowel transit time was (252.69 ± 113.29) min in treatment group and (258.75 ± 83.83) min in control group, there was no significant difference between two groups (P>0.05)., Conclusion: Metoclopramide may reduces gastric transit time, but not effect small bowel transit time,which suggests that it might increase the likelihood of complete small-bowel examination in patients undergoing capsule endoscopy.

Objective: To evaluate the value of deep small-bowel endoscopy (DSBE) in the diagnosis of Crohns disease (CD)., Methods: The endoscopic and clinical data of 54 patients with CD receiving capsule endoscopy (CE) and double-balloon enteroscopy (DBE) between January, 2004 and December, 2008 were summarized and analyzed retrospectively., Results: The main indications for DSBE in our series were suspected CD (42.6%) and obscure gastrointestinal bleeding (25.9%). DSBE was obviously superior to barium imaging. The detection rate of CD was significantly higher with DSBE (92.6%) than with ileocolonoscopy (75.9%, P=0.017), and DSBE provides much more detailed descriptions of specific endoscopic features such as segmental distribution and lumen changes. DSBE significantly improve the diagnostic efficiency, giving priority to offer a guide and raise suspected diagnosis for CD., Conclusion: DSBE is a valuable modality for detecting CD lesions in the jejunum and ileum and for evaluating lesion involvement and severity. The combination with a comprehensive analysis of routine imaging findings, gastro endoscopy, and clinical data can further enhance the diagnostic efficiency of DSBE.

Objective: To investigate the diagnostic value of capsule endoscopy (CE), CT enterography (CTE), ileocolonoscopy and small bowel follow through (SBFT) for small bowel Crohn's disease (CD)., Methods: Fifty-seven consecutive patients with CD underwent ileocolonoscopy, CTE, CE, and SBFT. It included the presence of the following symptoms and signs: abdominal pain, weight loss, diarrhea, fever and positive fecal occult blood test. The location and the characteristics of intestinal and extra-intestinal lesions detected by four techniques were compared. The proportions of patients with positive findings using each examination were compared., Results: Of the 57 patients, 50 underwent ileocolonoscopy, terminal ileum lesion was found in 33 patients (66.00%), the remaining 17 (34.0%) were normal; among 34 patients who had CTE, 29 of small bowel lesion were found (85.29%); CE were performed in 27 patients, due to prolonged gastric transit one time, the capsule did not reach the cecum in one patient during battery lifetime. CE showed small bowel lesion in 26 patients (96.30%); SBFT was performed in 39 patients and 26 of small bowel lesion were detected (66.67%). CE had the highest diagnostic yield for CD and ileocolonoscopy had the lowest, and there were statistically significant difference among the 4 examinations (P = 0.006). The combined positive rates of two methods were: CE + CTE 92.86% (13/14), SBFT + CTE 90.91% (20/22), CE + ileocolonoscopy 95.65% (22/23), CE + SBFT 100% (17/17), ileocolonoscopy + CTE 89.66% (26/29), ileocolonoscopy + SBFT 77.78% (28/36), but there were no significant differences between each two examinations., Conclusion: CE, CTE have a higher yield in depicting mild to moderate finding of CD than SBFT. CE is better for assessing early mucosal disease, whereas CTE is better for detecting transmural and extraluminal abnormalities. Most important, CE plus CTE may depict nonobstructive CD of the small bowel when conventional techniques such as ileocolonoscopy or SBFT have negative or inconclusive finding. CE provides us explanations for the symptoms of patients, decision to follow up or therapy.

Objective: To determine the efficiency and safety of capsule endoscopy for patients with intestinal diseases., Methods: Given M2A capsule endoscopy (CE) was performed on 81 patients with obscure gastrointestinal bleeding and obscure abdominal pain, and the clinical data were analyzed., Results: In the 81 patients, 9 showed negative finding, CE didn't reach the small intestine in 1 patient. In the other 71 patients, 132 intestinal lesions were detected, and the total positive rate of CE for intestinal diseases was 88.75%. The findings consisted of 36 intestinal inflammation, 24 angiopathy, 16 protuberant lesions, 15 mutipolypi in the intestine, 12 blood in the intestine, 11 single or multiple ulcers, 6 ascarid in the intestine, 5 diverticula, 1 ankylostomiasis, 1 intestinal dysplasia with internal fistula, and the 5 intestinal Crohn's disease. Ten patients with protuberant lesion were verified by surgical operation and pathology, and the 5 stromal tumors diagnosed by CE were confirmed by pathological examination, while no one of Crohn's disease, lymphoma and angioma was diagnosed correctly by CE. All images of CE were good. All the patients had no complications., Conclusion: Capsule endoscopy is a safe and effective procedure, with a high positive rate, but the diagnostic yield is limited, which can be used for intestinal diseases.

In order to determine the position of an intra-body microcapsule, the system based on alternating magnetic field has been promoted. According to the theory of three-dimensional localization system, the mathematical model has been ratiocinated. Composing and software design of the system are given. The result of the experiment has demonstrated that the system is feasible and it performs with high precision. The position error is less than 3 cm when the range is between 3 and 30cm. And the system has good anti-interference ability.

Objective: To evaluate the clinical utility of capsule endoscopy in diagnosing small bowel disease., Methods: A retrospective review of 155 cases undergone capsule endoscopy examinations from September 2002 to March 2007 in our hospital were performed. Gastric and small bowel transit time, patient tolerability, number of complete and incomplete examinations, and examination findings were evaluated., Results: A total of 155 cases were reviewed, and 159 times of capsule endoscopy examination were finished. Of the 155 patients, 97 suffered from obscure gastrointestinal bleeding, 42 abdominal pain, 6 abdominal discomfort, 4 diarrhea, and 6 body check. The capsule endoscopy examination for the entire small bowel were finished in 93.1%(148/159)cases. All the patients had no discomfortable feeling during the examinations. The capsule endoscopy remained in the stomach for an average of 65.5 min(1 to 335 min). The mean transit time in the small bowel was 282.2 min(45 to 524 min). The diagnostic yield of capsule endoscopy was 78.6%(125/159). Vasculopathy was present in 43.4% patients, enteritis in 28.3%, submucous knot in 10.1%, diverticulum of small intestine in 8.2%, and small intestine tumor in 5.7%. Other findings consisted of polyposis of small intestine, foreign objects and parasite. The diagnostic yield of obscure gastrointestinal bleeding by capsule endoscopy was 89.7%, and of abdominal pain was 73.8%., Conclusions: Capsule endoscopy is safe and well tolerated. Capsule endoscopy is a valuable diagnostic tool in the evaluation of occult small bowel disease, especially for obscure gastrointestinal bleeding.

Objective: To evaluate the diagnostic value of capsule endoscopy (CE) and multiple-detector computer tomography (MDCT) in obscure gastrointestinal bleeding., Methods: The diagnostic value of CE was compared with that of MDCT in patients with obscure gastrointestinal bleeding. 60 patients (35 men, 25 women; mean age 53.8 years, range 17 - 84 years) with obscure gastrointestinal bleeding were enrolled in the study. All underwent gastroscopy and colonoscopy, but definite diagnosis was not made, then all of them underwent MDCT followed by CE., Results: Natural excretion of the capsule occurred in 58 (96.7%) patients. CE identified positive findings in 36 (60.0%) patients and MDCT identified positive findings in 23 (38.3%) patients, P < 0.01. One patient was found to have 2 lesions simultaneously with CE. CE combined with MDCT identified positive findings in 40 (66.7%) patients. When this result was compared with that of CE, P > 0.05; whereas, compared with MDCT, P < 0.01. 28 patients underwent operations at last; the lesions accounting for bleeding all located in small intestine (16 in jejunum, 12 in ileum)., Conclusions: Diagnostic yield of CE was higher than that of MDCT in patients of obscure gastrointestinal bleeding. Combining CE with MDCT did not increase the diagnostic yield in obscure gastrointestinal bleeding. However, MDCT showed more extraintestinal lesions, it is suggested that patients with obscure gastrointestinal bleeding be examined not only with CE but also MDCT.

Objective: To investigate clinical diagnostic value of capsule endoscopy in obscure gastrointestinal bleeding., Methods: Capsule endoscopy were performed in 90 patients with obscure gastrointestinal bleeding, which was defined as negative finding by gastroscopy and colonoscopy in our hospital., Result: In 90 patients, 2 of them accepted second examination. Eighty-seven of 92 (94.57%) patients accepted of capsule endoscopy successfully including 21 of 25 (84.0%) in group of acute massive bleeding and 66 of 67 (98.51%) in recurrent melena (P <0.05). In above patients, 74 of 87 (85.06%) had positive findings and the false negative rate was 17.24%. The detectable rate in acute massive bleeding and recurrent melena was 80.95% and 86.36%, respectively (P >0.05), and the false negative rate of that was 23.81% and 15.15%, respectively (P >0.05)., Conclusion: Capsule endoscopy can be performed safely and well-toleratedly for visualizing the small bowel in patients with obscure gastrointestinal bleeding, which induces a highly detectable rate compared with other methods for detecting obscure gastrointestinal bleeding.