简介：技术突破推进了诊断成像的时间、空间的决定，并且3维(3-D)重建技术被介绍了进日常临床的实践。虚拟内视镜检查法(VE)是在3-D空格放大代表性的图象的感觉的一种非侵略的技术，提供病理学的区域和他们的包围结构的精确空间关系。许多计算机算法能被用来产生3-D图象，利用螺线计算了断层摄影术或磁性的回声成像(MRI)的在也固有的信息。VE图象通过空机关启用endoluminal航行，因此模仿常规内视镜检查法。几临床的研究验证了虚拟膀胱镜检查的诊断用途，它在膀胱肿瘤的察觉有高敏感和特性率。在肾盂，输尿管和尿道的虚拟探索的出版经验令人鼓舞却仍然少见。VE是一只保险箱，能与ureteropelvic连接阻塞在病人的长期的后续被使用的非侵略的方法，膀胱肿瘤和输尿管或尿道狭窄。它的主要限制是无能为组织病理学说的检查和联系电离放射危险提供活体检视织物标本(除非MRI被使用)。在endoluminal狭窄或阻塞的情况中，然而，VE向头部地允许虚拟endoluminal航行并且对小型机关枪的一种尾耳的片断。得出结论，VE提供评估泌尿道的一个不太侵略的方法，特别为比放射线学者不太熟悉代表性的成像的临床医生。

简介：AbstractArtificial intelligence (AI) is now a trendy subject in clinical medicine and especially in gastrointestinal (GI) endoscopy. AI has the potential to improve the quality of GI endoscopy at all levels. It will compensate for humans’ errors and limited capabilities by bringing more accuracy, consistency, and higher speed, making endoscopic procedures more efficient and of higher quality. AI showed great results in diagnostic and therapeutic endoscopy in all parts of the GI tract. More studies are still needed before the introduction of this new technology in our daily practice and clinical guidelines. Furthermore, ethical clearance and new legislations might be needed. In conclusion, the introduction of AI will be a big breakthrough in the field of GI endoscopy in the upcoming years. It has the potential to bring major improvements to GI endoscopy at all levels.

简介：AbstractThere has been a rapid increase in endoscopic ear surgery for the management of middle ear and lateral skull base disease in children and adults over the last decade. In this review paper, we discuss the current trends and applications of the endoscope in the field of otology and neurotology. Advantages of the endoscope include excellent ergonomics, compatibility with pediatric anatomy, and improved access to the middle ear through the external auditory canal. Transcanal endoscopic ear surgery has demonstrated comparable outcomes in the management of cholesteatoma, tympanic membrane perforations, and otosclerosis as compared to microscopic approaches, while utilizing less invasive surgical corridors and reducing the need for postauricular incisions. When a postauricular approach is required, the endoscopic-assisted transmastoid approach can avoid a canal wall down mastoidectomy in cases of cholesteatoma. The endoscope also has utility in treatment of superior canal dehiscence and various skull base lesions including glomus tumors, meningiomas, and vestibular schwannomas. Outside of the operating room, the endoscope can be used during examination of the outer and middle ear and for debridement of complex mastoid cavities. For these reasons, the endoscope is currently poised to transform the field of otology and neurotology.

简介：Preventionoflatecomplicationsafterlargeendoscopicresectionisinefficientwithcurrentmethods.Endoscopicshielding,asasimpleandsafetechnique,hasbeenproposedtoimprovetheincidenceoftheseevents.Differentmethods,sheetsorhydrogels,haveshowedprovenefficacyinthepreventionoflatebleedingandperforation,aswellastheimprovementoftissuerepair,inexperimentalmodelsandinclinicalpractice.

简介：AIM:ToevaluatethecompletionrateanddiagnosticyieldofthePillCamSB2-exincomparisontothePillCamSB2.METHODS:Twohundredcasesusingthe8-hPillCamSB2wereretrospectivelycomparedto200casesusingthe12hPillCamSB2-exatatertiaryacademiccenter.Endoscopicallyplacedcapsuleswereexcludedfromthestudy.Demographicinformation,indicationsforcapsuleendoscopy,capsuletype,studylength,completionofexam,clinicallysignificantfindings,timestampofmostdistantfinding...

简介：AbstractThe field of drug-induced sleep endoscopy (DISE) has grown considerably over the last 10~15 years, to now include its use in pediatric patients. In this review article, we outline our approach to the use of this technology in Children with Airway Obstruction, most specifically in the management of children with airway obstruction and known or suspected adenotonsillar enlargement.

简介：病人是有便血的一个33岁的人。结肠镜检查与流血揭示了分成小叶的梗节的息肉，在直径的大约40公里，在上升冒号。息肉有红、白的部件和一个马赛克模式。放大观察与扩大回合或卵形的地窟开始揭示了一个红崎岖表面部件，和光滑的白小瘤。内视镜的polypectomy被执行。标本的组织学的检查与膀胱的变化在薄板propria，平滑肌的增长，和增生的腺揭示了煽动性的肉芽组织。这息肉作为煽动性的myoglandular息肉(IMGP)被诊断。在上升冒号的由小叶片组成类型的IMGP是稀罕的。

简介：AIMtotestthefeasibilityandperformanceofanoveluppergastrointestinal(GI)capsuleendoscopeusinganurse-ledprotocol.METHODSWeconductedaprospectivecohortanalysisofpatientswhodeclinedgastroscopy(oesophagogastroduodenoscopy,OGD)butwhoconsentedtoupperGIcapsuleendoscopy.PatientsswallowedtheupperGIcapsulefollowingingestionof1literofwater(containingsimethicone).AseriesofpositionalchangeswereusedtoexploittheeffectsofwaterflowandmovetheupperGIcapsulefromonegravity-dependentareatoanotherusinganurse-ledprotocol.Capsuletransittime,videoreadingtime,mucosalvisualisation,pathologydetectionandpatienttolerancewasevaluated.RESULTSFiftypatientswereincludedinthestudy.Themeancapsuletransittimesintheoesophagusandstomachwere28sand68minrespectively.Visualisationofthefollowingmajoranatomicallandmarkswasachieved(graded1-5:Poortoexcellent):Oesophagus,4.8(±0.5);gastro-oesophagealjunction(GOJ),4.8(±0.8);cardia,4.8(±0.8);fundus,3.8(±1.2);body,4.5(±1);antrum,4.5(±1);pylorus,4.7(±0.8);duodenalbulb,4.7(±0.7);secondpartoftheduodenum(D2),4.7(±1).TheupperGIcapsulereachedD2in64%ofpatients.Themeanvideoreadingtimewas48minwithstandardplaybackmodeand20minusingQuickview(p=0.0001).NopathologywasmissedusingQuickview.Proceduraltolerancewasexcellent.NocomplicationswereseenwiththeupperGIcapsule.CONCLUSIONTheupperGIcapsuleachievedexcellentviewsoftheupperGItract.FuturestudiesshouldcomparethediagnosticaccuracybetweenupperGIcapsuleandOGD.

简介：Superficialnon-ampullaryduodenalepithelialtumor(SNADET)isdefinedasasporadictumorthatisconfinedtothemucosaorsubmucosathatdoesnotarisefromVater’spapilla,anditincludesadenomaandadenocarcinoma.Recentdevelopmentsinendoscopictechnology,suchashigh-resolutionendoscopyandimage-enhancedendoscopy,mayincreasethechancesofdetectingSNADETlesions.However,becauseSNADETisrare,littleisknownaboutitspreoperativeendoscopicdiagnosis.TheuseofendoscopicresectionforSNADET,whichhasnoriskofmetastasis,isincreasing,buttheincidenceofcomplications,suchasperforation,issignificantlyhigherthaninanyotherpartofthedigestivetract.Apreoperativediagnosisisrequiredtodistinguishbetweenlesionsthatshouldbefollowedupandthosethatrequiretreatment.Retrospectivestudieshaverevealedcertainendoscopicfindingsthatsuggestmalignancy.Inrecentyears,severalnewimagingmodalitieshavebeendevelopedandexploredforrealtimediagnosisoftheselesiontypes.EstablishinganendoscopicdiagnostictooltodifferentiatebetweenadenomaandadenocarcinomainSNADETlesionsisrequiredtoselectthemostappropriatetreatment.ThisreviewdescribesthecurrentstateofknowledgeaboutpreoperativeendoscopicdiagnosisofSNADETs,suchasduodenaladenomaandduodenaladenocarcinoma.Newerendoscopictechniques,includingmagnifyingendoscopy,mayhelptoguidethesediagnostics,buttheiradditionaladvantagesremainunclear,andfurtherstudiesarerequiredtoclarifytheseissues.

简介：ObjectiveToexplorethevalueofcomputedtomographyvirtualendoscopy(VE)inassessingossicularchaindisruptionintemporalbonefractureandeartraumawithintacttympanum.MethodsHighresolutionspiralcomputerizedtomography(CT)wascompletedin35casesoftemporalbonefractureand5casesoftympanumtrauma,allwithintactorhealedtympanum.Three-dimensionalreconstructionwascompletedus-ingavirtualendoscopysoftware.Audiologicaltestswereconductedinallpatientsandevaluationoffacialnerveinjuryinpatientswithfacialparalysis.Patientswithmildconductivedeafness,ossicularchainsublux-ationonVE,andnofacialparalysisweretreatedconservativelyfor4-12weekswithrepeatedhearingevalu-ation;thosewithfacialparalysisunderwentsurgeryifnorecoveryafter4-8weeksofconservativetreat-ment.Patientswithmoderatetosevereconductivehearinglossormixedhearingloss,incuslongprocessfractureordislocationonVEandfacialparalysis,underwentossicularchainreconstructionandfacialnervedecompressionafterconservativetreatmentfor4-8weeks,orexploratorytympanotomyonlyifnofacialpa-ralysis.VE,audiologicaltestsandfacialnervefunctiontestswererepeatedin3-6monthsaftersurgery.Re-sultsOfthe6caseswithmildconductivehearingloss,ossicularchainsubluxationandnofacialparalysis,3recoveredtonormalhearingspontaneouslyand3showednosignificantimprovement,after4-12weeksofconservativetreatment.Afterconservativetreatmentfor4-8weeks,3ofthe12caseswithmildconductivedeafness,ossicularchaindislocationonVEandfacialparalysisrecoveredtonormalhearingandHouse-Brackmann(HB)gradeIfacialfunctionfromHBgradeII,4showedfacialfunctionrecoverytoHBgradeI(n=2)orII(n=2)fromHBgradeIIIbutnohearingrecovery,and5gainednorecoveryandwentontoreceiveexploratorytympanotomyandfacialnervedecompression.The11caseswithmoderatetosevereconductivedeafness,incuslongprocessfr

简介：ObjectiveToexplorethevalueofcomputedtomographyvirtualendoscopy(VE)inassessingossicularchaindisruptionintemporalbonefractureandeartraumawithintacttympanum.MethodsHighresolutionspiralcomputerizedtomography(CT)wascompletedin35casesoftemporalbonefractureand5casesoftympanumtrauma,allwithintactorhealedtympanum.Three-dimensionalreconstructionwascompletedusingavirtualendoscopysoftware.Audiologicaltestswereconductedinallpatientsandevaluationoffacialnerveinjuryinpatientswithfacialparalysis.Patientswithmildconductivedeafness,ossicularchainsubluxationonVE,andnofacialparalysisweretreatedconservativelyfor4-12weekswithrepeatedhearingevaluation;thosewithfacialparalysisunderwentsurgeryifnorecoveryafter4-8weeksofconservativetreatment.Patientswithmoderatetosevereconductivehearinglossormixedhearingloss,incuslongprocessfractureordislocationonVEandfacialparalysis,underwentossicularchainreconstructionandfacialnervedecompressionafterconservativetreatmentfor4-8weeks,orexploratorytympanotomyonlyifnofacialparalysis.VE,audiologicaltestsandfacialnervefunctiontestswererepeatedin3-6monthsaftersurgery.ResultsOfthe6caseswithmildconductivehearingloss,ossicularchainsubluxationandnofacialparalysis,3recoveredtonormalhearingspontaneouslyand3showednosignificantimprovement,after4-12weeksofconservativetreatment.Afterconservativetreatmentfor4-8weeks,3ofthe12caseswithmildconductivedeafness,ossicularchaindislocationonVEandfacialparalysisrecoveredtonormalhearingandHouseBrackmann(HB)gradeIfacialfunctionfromHBgradeII,4showedfacialfunctionrecoverytoHBgradeI(n=2)orII(n=2)fromHBgradeIIIbutnohearingrecovery,and5gainednorecoveryandwentontoreceiveexploratorytympanotomyandfacialnervedecompression.The11caseswithmoderatetosevereconductivedeafness,incuslongprocessfractureordis

简介：AbstractBackground:Worldwide, the volume and availability of digestive endoscopy have undergone dramatic development in recent years, with increasing attention on quality assurance. We investigated the utilization and quality of digestive endoscopy in China from 2015 to 2019 and developed a quantitative quality evaluation tool for medical institutions.Methods:We invited all tertiary/secondary hospitals in Chinese mainland to participate in the survey annually. The questionnaires included the personnel, annual volume, and quality indicators of endoscopy. An endoscopy quality index (EQI) was developed based on recorded quality indicators using principal component analysis to determine the relative weight.Results:From 2015 to 2019, 806, 1412, 2644, 2468, and 2541 hospitals were respectively enrolled in this study. The average annual volume of endoscopy increased from 12,445 to 16,206 (1.30-fold) and from 2938 to 4255 (1.45-fold) in tertiary and secondary hospitals, respectively. The most obvious growth was observed in diagnostic colonoscopy (1.44-fold for all hospitals after standardization). The proportion of early cancer among all esophageal and gastric cancers during diagnostic esophagogastroduodenoscopy increased from 12.3% (55,210/448,861) to 17.7% (85,429/482,647) and from 11.4% (69,411/608,866) to 16.9% (107,192/634,235), respectively. The adenoma detection rate of diagnostic colonoscopy increased from 14.9% (2,118,123/14,215,592) to 19.3% (3,943,203/20,431,104). The EQI model included 12 quality indicators, incorporating 64.9% (7.792/12) of the total variance into one comprehensive index. According to the EQI measurements, the quality of endoscopy was higher in tertiary hospitals and hospitals in developed areas with higher volume or more endoscopists than that in other hospitals.Conclusions:Digestive endoscopy in China has developed considerably in recent years in terms of both volume and quality. The EQI is a promising tool to quantify the quality of endoscopy at different hospitals.