目的 通过戴明循环管理法的品管圈（QCC）活动, 提升内镜中心病理标本标识的正确率与病理标本管理安全性。方法 采用基于戴明循环管理法的QCC活动, 对内镜中心病理标本标识质量进行现状把握、原因分析并制定对策, 比较QCC活动开展前后内镜病理标本标识的正确率。结果 QCC活动后, 内镜中心病理标本标识的正确率从99.8%提高至100%（P<0.05）。结论 内镜中心通过开展基于戴明循环管理法的QCC活动, 显著提升了内镜病理标本管理安全性与工作效率。

       Objective To improve the accuracy of pathological specimen identification and the safety of pathological specimen management in endoscopy center through quality control circle（QCC）activity based on Deming cycle management．Methods QCC activity based on Deming cycle management was used to summarize the status quo,analyze the causes and formulate countermeasures for the quality control of pathological specimen identification in endoscopy center．The accuracy rate of endoscopic pathological specimen identification before and after QCC activity was compared．Results After QCC activity, the accuracy of pathological specimen identification in endoscope center increased from 99.8% to 100%．Conclusions QCC activities based on Deming cycle management can greatly improve the safety and efficiency of endoscopic pathological specimen management．

消化系统疾病诊治与组织病理诊断密切相关,高效、规范获取组织样本是关键,对此2021年欧洲胃肠内镜学会制定了消化道及肝胰腺胆道的内镜下组织活检的指南,分为上消化道（含肝、胰腺、胆道）和下消化道两部分,提供了规范活检的指导及建议。笔者对指南就上消化道内镜下组织活检的部分内容进行解读,解读内容为个人观点。

The diagnosis and treatment of digestive system diseases are closely related to histopathological diagnosis．Efficient and standardized acquisition of tissue samples plays a key role．In 2021,European Society of Gastrointestinal Endoscopy（ESGE）had developed guidelines for endoscopic tissue biopsy of the digestive tract and hepatopancreatic biliary tract,which divided into upper gastrointestinal tract（including liver,pancreas,biliary tract）and lower gastrointestinal tract．This guideline provided guidance and recommendations for standardizing biopsies．We interprets some of the contents of the guideline on tissue biopsy under endoscopy of the upper gastrointestinal tract,which are personal opinions．

目的 粪菌移植(fecal microbiota transplantation,FMT)是治疗疾病的新途径,本文总结我院408例(1 085例次)FMT的临床疗效和安全性。FMT治疗艰难梭菌感染有效率达80%,抗生素相关性腹泻68%,炎症性肠病52%,功能性肠病65%,代谢性疾病50%,其他疾病57%,安全性良好,未见严重不良事件发生,结果和多数文献相符。还需更多随机对照试验才能明确FMT的临床价值。

目的 探讨粪菌移植(FMT)在两种肠镜下盲肠置管术的临床应用。方法 将2016年1月—2017年6月在我院通过肠镜下盲肠置管术进行粪菌移植的200例患者,随机分为A组和B组,各100例。A组采用直接肠镜置管法完成置管,B组采用二次肠镜置管法完成置管,对两组操作的置管成功率、置管时间、平均疼痛评分、并发症等情况进行对比。结果 与A组相比较,B组到达盲肠时间略长但无统计学意义(14.95min vs 15.26min,P=0.68)、疼痛评分低(5.7 vs 4.8,P<0.05)、更低的并发症发生率(6 % vs 23 %,P<0.05)。结论 在粪菌移植内镜下盲肠置管术患者中,采用通过采用二次肠镜置管法与直接肠镜法相比较完成置管手术时间无统计学差异,但置管成功率高、患者的痛苦小、风险低,值得临床推广。

Objective To investigate the clinical application of fecal microbiota transplantation (FMT) in two kinds of colonoscopic cecal catheterization. Methods From January 2016 to June 2017, 200 patients who took colonoscopic cecal catheterization for fecal microbiota transplantation in our hospital were randomly divided into group A and group B, with 100 patients in each group.Group A used direct colonoscopy catheterization to complete catheterization, group B was treated by the second colonoscopy catheterization. The success rate of catheterization, catheterization time, average pain score and complication were compared between the two groups. Results Compared with group A, the time to reach the cecum in group B was slightly longer but not statistically significant (14.95min vs 15.26min,P=0.68). It had lower pain score (5.7 vs 4.8, P<0.05), lower complication rate. Conclusion Among the patients with colonoscopic cecal catheterization for fecal microbiota transplantation, there was no significant difference in the time of catheterization between the second colonoscopy and the direct colonoscopy, but it has the high success rate of catheterization and low pain, low risk, worthy of clinical promotion.