Diagnostic value of confocal laser endomicroscopy in primary bile reflux gastritis

胰腺内副脾误诊2例报告张孟哲，饶洁，张正乐武汉大学人民医院胰腺外科，武汉 430060通信作者：张正乐，**************（ORCID： 0000-0003-1895-4366）摘要：副脾是指正常脾脏以外存在的，与主脾结构相似，有一定功能的脾脏组织，其中完全被胰腺包裹的胰腺内副脾（IPAS）发生率仅为2%，因其临床症状不典型，影像学特征与胰腺神经内分泌肿瘤、胰腺实性假乳头状瘤以及其他胰腺占位性病变较为相似，临床上容易误诊。

本文报道了2例分别被误诊为胰腺神经内分泌肿瘤和胰腺实性假乳头状瘤的IPAS患者，并分析误诊原因，总结诊疗经验，以期提升临床对IPAS明确鉴别诊断的认识。

关键词：脾疾病；胰腺；误诊；神经内分泌瘤；乳头状瘤Misdiagnosis of intrapancreatic accessory spleen： A report of two casesZHANG Mengzhe， RAO Jie， ZHANG Zhengle.（Department of Pancreatic Surgery， Renmin Hospital of Wuhan University， Wuhan 430060， China）Corresponding author： ZHANG Zhengle，**************（ORCID： 0000-0003-1895-4366）Abstract：Accessory spleen refers to the spleen tissue that exists outside of the normal spleen， with a similar structure to the main spleen and certain functions. Intrapancreatic accessory spleen （IPAS） completely enveloped by the pancreas has an incidence rate of only 2%， and it is easily misdiagnosed in clinical practice due to its atypical clinical symptoms and similar radiological features to pancreatic neuroendocrine tumor，pancreatic solid pseudopapillary tumor，and other pancreatic space-occupying lesions. This article reports the clinical data of two patients with IPAS who were misdiagnosed as pancreatic neuroendocrine tumor and pancreatic solid pseudopapillary tumor， respectively， analyzes the reasons for misdiagnosis， and summarizes the experience in diagnosis and treatment， in order to improve the ability for the differential diagnosis of IPAS in clinical practice.Key words：Splenic Diseases； Pancreas； Diagnostic Errors； Neuroendocrine Tumors； Papilloma1　病例资料病例1：患者女性，58岁，以“体检发现胰腺尾部占位3天”于2019年3月4日入本院，患者2年来体质量下降5 kg，增强CT检查示：胰腺尾部动脉期以及门静脉期显著强化结节，动脉期CT值为198 HU，考虑神经内分泌肿瘤（图1）。

睑板腺功能障碍相关干眼的临床检查进展张丽琴;陈子林【摘要】Dry eye is one of the most commonly encountered problems in ophthalmology .Both aqueous tear deficiency and increasing evaporation lead to dry eye .It has been recognized that meibomian gland dysfunction plays an important role in the causes of dry eye .To make a diagnosis ofdry eye which is mainly caused by meibomian gland dysfunction ,the doctors should learn about the symptoms ,signs and clinical examinationsof the patients .There are a variety of clinical examinations in the diagnosis of dry eye.Current clinical examinations of diagnosis include Schirmertest ,tear break-up time and so on. Emerging technologies include OCULUS Keratograph ,interferometry,tear osmolarity and so on.It′s expected to find a readily available,reproducible and objective diagnostic test for dry eye .%干眼是临床上常见的眼科疾病之一，包括泪液分泌不足引起的干眼和泪液蒸发过强引起的干眼。

·专家论坛·总之，虚拟导航不失为一个对肺外周病灶活检的良好辅助工具，对国内大多数医院而言，如何简化流程、让这项技术日常便利化则还需做些工作。

2.5 其他辅助技术为提高早期周围型肺癌的诊断率，多种支气管镜检查相关的辅助技术也在临床中开展或探索中。

快速现场病理评估（rapid on-site evaluation, ROSE）有助于反馈是否活检到恶性细胞，提高肺外周病灶的活检诊断率，减少不必要的活检次数。

对于难以活检诊断的特殊病例，通过引导鞘对病灶行细针穿刺、冲洗液检查，也有助于提高诊断率。

总之，随着各种新技术的应用，我国支气管镜诊断早期肺癌的水平已大大提高；一些新技术还在探索和完善阶段，不能苛求，需要更多的研究去证实其实用价值。

低剂量CT对肺癌高危人群的筛查可以大大降低肺癌的死亡率，与其相比，目前还没有任何一项气管镜技术被大规模的临床试验证实有早期肺癌筛查的实用价值，我们在这方面还任重而道远。

参考文献[1] Lam S, Kennedy T, Unger M, et al. Localization ofbronchial intraepithelial neoplastic lesions by fluorescence bronchoscopy[J]. Chest, 1998, 113(3): 696-702.[2] Häussinger K, Becker H, Stanzel F, et al. Autofluorescencebronchoscopy with white light bronchoscopy comparedwith white light bronchoscopy alone for the detection of precancerouslesions: a European randomised controlled multicentre trial[J]. Thorax, 2005, 60(6): 496-503.[3] 孙艳, 朱廷昌. WLB联合AFI技术对支气管腔内肺癌早期诊断价值的研究[J]. 中国继续医学教育, 2016, 8(29): 83-84.[4] Venmans BJ, van Boxem TJ, Smit EF, et al. Outcome ofbronchial carcinoma in situ[J]. Chest, 2000, 117(6): 1572-1576.[5] Tremblay A, Taghizadeh N, McWilliams AM, et al.Low prevalence of high-grade lesions detected withautofluorescence bronchoscopy in the setting of lung cancer screening in the pan-canadian lung cancer screening study[J].Chest, 2016, 150(5): 1015-1022.[6] Vincent BD, Mostafa F, Silvestri GA. A pilot study of narrow-band imaging compared to white light bronchoscopy for evaluation of normal airways and premalignant and malignant airways disease[J]. Chest, 2007, 131(6): 1794-1799．[7] Iftikhar IH, Musani AI. Narrow-band imaging bronchoscopyin the detection of premalignant airway lesions: a meta-analysis of diagnostic test accuracy[J]. Ther Adv Respir Dis, 2015, 9(5): 207-216.[8] Shibuya K, Hoshino H, Chiyo M, et al. Subepithelial vascularpatterns in bronchial dysplasias using a high magnification bronchovideoscope[J]. Thorax, 2002, 57(10): 902-907. [9] Fuchs FS, Zirlik S, Hildner K, et al. Confocal laserendomicroscopy for diagnosing lung cancer in vivo[J]. Eur Respir J, 2013, 41(6): 1401-1408.[10] Hariri LP, Mino-Kenudson M, Lanuti M, et al. Diagnosinglung carcinomas with optical coherence tomography[J]. Ann Am Thorac Soc, 2015, 12(2): 193-201.[11] Tamiya M, Okamoto N, Sasada S, et al. Diagnostic yield ofcombined bronchoscopy and endobronchial ultrasonography, under LungPoint guidance for small peripheral pulmonary lesions. Respirology[J]. Respirology, 2013, 18(5): 834-839.[12] Steinfort DP, Khor YH, Manser RL, et al. Radial probeendobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis[J]. Eur Respir J, 2011, 37(4): 902-910.[13] 张辉军, 张龙富, 叶茂松, 等. 国产电磁导航支气管镜检查定位系统引导经支气管镜肺活检术对肺外周病灶的诊断价值[J]. 复旦学报（医学版）, 2017, 44(3): 348-352. [14] Ishida T, Asano F, Yamazaki K, et al. Virtual bronchoscopicnavigation combined with endobronchial ultrasound to diagnose small peripheral pulmonary lesions: a randomised trial[J]. Thorax, 2011, 66(12): 1072-1077.（收稿日期：2018-03-19）《上海医药》杂志携手美优制药撰写合理用药宣传册为了深入开展合理用药宣传教育，方便医师、药师查询药物信息，帮助基层医生尽快熟悉止咳化痰类药物的使用规范，《上海医药》杂志编辑部联合美优制药及多家三甲医院的医师、药师，拟于2018年上半年出版以“合理使用止咳化痰类药物”为主要内容的宣传册。

-722.-inflammatory activity of flower-120.、抑菌-35.RCM 目前已经广泛应用于皮真菌菌丝检出率较高；手足口病见表皮内密集多房性小水疱等。

希望RCM 能为常见感染性皮肤病的诊断及鉴别诊断提供更多帮助。

【关键词】　反射式共聚焦显微镜；感染性皮肤病；疾病诊断中图分类号：R443+.9；R752/753 文献标志码：A doi ：10.3969/j.issn.1002-1310.2020.06.006Applicaton of reflectance confocal microscopy in infectious skin diseasesZHANG Yan -xiu,ZHENG Bao -yong ※,ZHAO Wei -hong,NIE Ting -fen,WU Jin -huan（Baodi Clinical College of Tianjin Medical University/Dermatology Department of Tianjin Baodi Hospital,Tianjin 301800,China ）【Abstract 】　Reflectance confocal microscopy(RCM), it is a new diagnostic method in dermotology, and the application for diagnosis of many skin diseases is becoming more and more mature. RCM has been widely used in the diagnosis and treatment of skin tumors and pigmentation skin deseases. This paper summarizes the RCM manifestations of several common infectious dermatoses: Herpetic dermatosis, high refractive disc cells can be seen in the epidermis; Verruca plana, the cells of stratum granulosum and upper stratum spinosum arrange in concentric circles; Rosacea, demodex overbreeding in hair follicles; In tinea manus and pedis, the detection rate of fungi is high by RCM; Hand -food -mouth disease, dense multilocular blisters in epidermis. It is hoped that RCM will provide more help for the diagnosis and differential diagnosis of common infectious dermatoses.【Key words 】　Reflectance confocal microscopy;Infectious skin diseases; Disease diagnosis【收稿日期】2020-01-13　※通信作者E -mail ：********************感染性皮肤病是由病原体感染皮肤黏膜引起的疾病，诊断主要依据临床表现及实验室检查。

V N 共聚焦激光显微内镜在体诊断幽门螺杆菌感染的应用探讨刘福国1赵幼安2王岩2李延青2郭玉婷2刘红2（1潍坊市益都中心医院2625002山东大学齐鲁医院消化内科）【摘要】目的探讨共聚焦激光显微内镜在体诊断幽门螺杆菌（Hp ）感染的可行性及其临床应用价值。

方法对23例进行上消化道内镜检查的患者应用共聚焦激光显微内镜在体诊断有无H p 感染，并与活检组织W ar t hi n-St ar r y 银染色结果比较。

结果23例患者中13例存在H p 感染，其中12例经共聚焦激光显微内镜诊断证实。

有3例共聚焦激光显微内镜检查发现H p 感染而W a r t hi n-St a r r y 银染色未发现H p 。

结论共聚焦激光显微内镜检查是临床在体诊断幽门螺杆菌感染较为可靠的方法【关键词】共聚焦激光显微内镜；幽门螺杆菌；诊断The Approach of Confocal Laser Endomicroscopy in Diagnosing Helicobacter Pylori Infection in VivoLIU Fu -guo Z HAO Y ou -an W ANG Y a n LI Y a n-q ing GUO Y u -ting LIU Ho ng Department o f Ga stroen t er ology,Qilu Ho spital of Shand ong Un i versi ty ,250012,Chin a[Ab str act]Ob jective:To approach the valu e o f confocal las er end omicroscopy in diagn osing Helicob acter pyloriin fectio n in vivo.M ethod :Helicobacter pylori infection was d etected by co nfocal laser endo microscopy and W arth in -Starry silver stain in 23patients.Results:13p atien ts was infected by Helicob acter pylori and confocal las er end omicroscopy detected Helicobacter pylori in 12o f them.3patients with Helicobacter pylori infection were detected by confocal laser endomicros copy but not Warthin-Starry silver stain.Conclus ion:Confocal laser endomicroscopy i s a reliable method in diagno sin g Helicob acter pylori infection in vivo.[Key wo rds ]Confo cal laser endo micro sco py;Helicobacter pylori;Diagnose通讯作者：赵幼安：z y @63侵入性幽门螺杆菌（H el i cobact er Pyl or i ，H p ）感染诊断方法如W ar t hi n-St ar r y 银染色、细菌培养需取黏膜活检组织体外检测、且需时较长，而非侵入性检查如尿素呼气试验、粪便抗原检测则需有一定定植密度的H p 且有一定的假阳性和假阴性，均不能在体内实时观察H p 的定植部位及其密度。

蓝激光成像技术在上消化道早癌中的诊断价值余超;贺亚敏;肖君【摘要】上消化道早癌是近年来国内外研究的热点话题,定义为浸润深度不超过黏膜下层或局限于黏膜层的消化道癌症,包括早期食管癌、早期胃癌;由于一些病灶微小,普通内镜不易发现,容易漏诊和误诊.消化内镜诊疗技术如窄带成像技术(narrow band imaging, NBI)、超声内镜(endoscopic ultrasonography, EUS)、共聚焦激光显微内镜(confocal laser endomicropy, CLE)、智能电子分光技术(Fuji intelligent chromo-endoscopy, FICE)的发展,明显提高了上消化道早癌的诊断能力.消化内镜已由过去单纯的诊断演变为诊断与治疗为一体的重要工具.本文主要分析富士新型蓝激光成像技术(blue laser imaging, BLI)在上消化道早癌中的应用,为临床诊疗提供参考依据.%Early carcinoma of upper gastrointestinal tract is a hot topic in the researches at home and abroad in recent years.It defined as infiltrating depth is less than submucosa or confined to mucous membrane layer of the digestive tract cancer, including early carcinoma of esophagus and stomach.Traditional endoscopy is difficult to find some tiny lesions, easily missed diagnosis and misdiagnosis.With the development of gastrointestinal endoscopic diagnosis and treatment technology, such as narrow band imaging (NBI), endoscopic ultrasonography (EUS), confocal laser endomicropy (CLE), Fuji intelligent chromo-endoscopy (FICE).The diagnostic ability of early carcinoma of upper gastrointestinal tract is obviously improved.Gastrointestinal endoscopy has evolved from the simple diagnostic tool to the important means of diagnosis and treatment integration.This paper mainly analyzed the Fuji new technology of bluelaser imaging (BLI) system, which was applicated in the early carcinoma of upper gastrointestinal tract, and provided reference basis for clinical diagnosis and treatment.【期刊名称】《胃肠病学和肝病学杂志》【年(卷),期】2017(026)009【总页数】5页(P1061-1065)【关键词】蓝激光成像技术;上消化道早癌;诊断【作者】余超;贺亚敏;肖君【作者单位】南京中医药大学附属医院消化内镜中心南京中医药大学第一临床医学院,江苏南京 210000;江苏省中医院病理科;江苏省中医院消化内镜中心【正文语种】中文【中图分类】R735我国是消化系恶性肿瘤高发国家，流行病学调查结果显示，消化系恶性肿瘤占总恶性肿瘤发病数的一半以上，其中胃癌、结直肠癌、食管癌分别居肿瘤发病的第1、4、6位。

MPU-6881 Product Specification Revision 1.0TABLE OF CONTENTSTABLE OF FIGURES (4)TABLE OF TABLES (5)1DOCUMENT INFORMATION (6)1.1R EVISION H ISTORY (6)1.2P URPOSE AND S COPE (7)1.3P RODUCT O VERVIEW (7)1.4A PPLICATIONS (7)2FEATURES (8)2.1G YROSCOPE F EATURES (8)2.2A CCELEROMETER F EATURES (8)2.3A DDITIONAL F EATURES (8)3ELECTRICAL CHARACTERISTICS (9)3.1G YROSCOPE S PECIFICATIONS (9)3.2A CCELEROMETER S PECIFICATIONS (10)3.3E LECTRICAL S PECIFICATIONS (11)3.4I2C T IMING C HARACTERIZATION (15)3.5SPI T IMING C HARACTERIZATION (16)3.6A BSOLUTE M AXIMUM R ATINGS (18)4APPLICATIONS INFORMATION (19)4.1P IN O UT D IAGRAM AND S IGNAL D ESCRIPTION (19)4.2T YPICAL O PERATING C IRCUIT (20)4.3B ILL OF M ATERIALS FOR E XTERNAL C OMPONENTS (20)4.4B LOCK D IAGRAM (21)4.5O VERVIEW (21)4.6T HREE-A XIS MEMS G YROSCOPE WITH 16-BIT ADC S AND S IGNAL C ONDITIONING (22)4.7T HREE-A XIS MEMS A CCELEROMETER WITH 16-BIT ADC S AND S IGNAL C ONDITIONING (22)4.8I2C AND SPI S ERIAL C OMMUNICATIONS I NTERFACES (22)4.9S ELF-T EST (24)4.10C LOCKING (25)4.11S ENSOR D ATA R EGISTERS (25)4.12FIFO (25)4.13I NTERRUPTS (25)4.14D IGITAL-O UTPUT T EMPERATURE S ENSOR (25)4.15B IAS AND LDO S (26)4.16C HARGE P UMP (26)4.17S TANDARD P OWER M ODES (26)5PROGRAMMABLE INTERRUPTS (27)6DIGITAL INTERFACE (28)6.1I2C AND SPI S ERIAL I NTERFACES (28)6.2I2C I NTERFACE (28)6.3I2C C OMMUNICATIONS P ROTOCOL (28)6.4I2C T ERMS (31)6.5SPI I NTERFACE (32)7SERIAL INTERFACE CONSIDERATIONS (32)7.1MPU-6881S UPPORTED I NTERFACES (33)8ASSEMBLY (34)8.1O RIENTATION OF A XES (34)8.2P ACKAGE D IMENSIONS (35)9PART NUMBER PACKAGE MARKING (36)10RELIABILITY (37)10.1Q UALIFICATION T EST P OLICY (37)10.2Q UALIFICATION T EST P LAN (37)11REFERENCE (38)Table of FiguresFigure 1 I2C Bus Timing Diagram (15)Figure 2 SPI Bus Timing Diagram (16)Figure 3 Pin out Diagram for MPU-6881 3.0x3.0x0.9mm QFN (19)Figure 4 MPU-6881 QFN Application Schematic. (a) I2C operation, (b) SPI operation. (20)Figure 5 MPU-6881 Block Diagram (21)Figure 6 MPU-6881 Solution Using I2C Interface (23)Figure 7 MPU-6881 Solution Using SPI Interface (24)Figure 8 START and STOP Conditions (29)Figure 9 Acknowledge on the I2C Bus (29)Figure 10 Complete I2C Data Transfer (30)Figure 11 Typical SPI Master / Slave Configuration (32)Figure 12 I/O Levels and Connections (33)Figure 13 Orientation of Axes Sensitivity and Polarity of Rotation (34)Table of TablesTable 1 Gyroscope Specifications (9)Table 2 Accelerometer Specifications (10)Table 3 D.C. Electrical Characteristics (11)Table 4 A.C. Electrical Characteristics (13)Table 5 Other Electrical Specifications (14)Table 6 I2C Timing Characteristics (15)Table 7 SPI Timing Characteristics (16)Table 8 fCLK = 20MHz (17)Table 9 Absolute Maximum Ratings (18)Table 10 Signal Descriptions (19)Table 11 Bill of Materials (20)Table 12 Standard Power Modes for MPU-6881 (26)Table 13 Table of Interrupt Sources (27)Table 14 Serial Interface (28)Table 15 I2C Terms (31)1 Document Information1.2 Purpose and ScopeThis document is a preliminary product specification, providing a description, specifications, and design related information on the MPU-6881™ MotionTracking device. The device is housed in a small 3x3x0.9mm 24-pin QFN package.Specifications are subject to change without notice. Final specifications will be updated based upon characterization of production silicon. For references to register map and descriptions of individual registers, please refer to the MPU-6881 Register Map and Register Descriptions document.1.3 Product OverviewThe MPU-6881 is a 6-axis MotionTracking device that combines a 3-axis gyroscope, and a 3-axis accelerometer in a small 3x3x0.9mm (24-pin QFN) package. It also features a 4096-byte FIFO that can lower the traffic on the serial bus interface, and reduce power consumption by allowing the system processor to burst read sensor data and then go into a low-power mode. With its dedicated I2C sensor bus, the MPU-6881 directly accepts inputs from external I2C devices. MPU-6881, with its 6-axis integration, enables manufacturers to eliminate the costly and complex selection, qualification, and system level integration of discrete devices, guaranteeing optimal motion performance for consumers. MPU-6881 is also designed to interface with multiple non-inertial digital sensors, such as pressure sensors, on its auxiliary I2C port.The gyroscope has a programmable full-scale range of ±250, ±500, ±1000, and ±2000 degrees/sec. The accelerometer has a user-programmable accelerometer full-scale range of ±2g, ±4g, ±8g, and ±16g. Factory-calibrated initial sensitivity of both sensors reduces production-line calibration requirements.Other industry-leading features include on-chip 16-bit ADCs, programmable digital filters, a precision clock with 1% drift from -40°C to 85°C, an embedded temperature sensor, and programmable interrupts. The device features I2C and SPI serial interfaces, a VDD operating range of 1.71 to 3.45V, and a separate digital IO supply, VDDIO from 1.71V to 3.45V.Communication with all registers of the device is performed using either I2C at 400kHz or SPI at 1MHz. For applications requiring faster communications, the sensor and interrupt registers may be read using SPI at 20MHz.By leveraging its patented and volume-proven CMOS-MEMS Fabrication platform, which integrates MEMS wafers with companion CMOS electronics through wafer-level bonding, InvenSense has driven the package size down to a footprint and thickness of 3x3x0.9mm (24-pin QFN), to provide a very small yet high performance low cost package. The device provides high robustness by supporting 10,000g shock reliability.1.4 Applications∙TouchAnywhere™ technology (for “no touch” UI Application Control/Navigation)∙MotionCommand™ technology (for Gesture S hort-cuts)∙Motion-enabled game and application framework∙Location based services, points of interest, and dead reckoning∙Handset and portable gaming∙Motion-based game controllers∙3D remote controls for Internet connected DTVs and set top boxes, 3D mice∙Wearable sensors for health, fitness and sports2 Features2.1 Gyroscope FeaturesThe triple-axis MEMS gyroscope in the MPU-6881 includes a wide range of features:∙Digital-output X-, Y-, and Z-axis angular rate sensors (gyroscopes) with a user-programmable full-scale range of ±250, ±500, ±1000, and ±2000°/sec and integrated 16-bit ADCs ∙Digitally-programmable low-pass filter∙Gyroscope operating current: 3.2mA∙Factory calibrated sensitivity scale factor∙Self-test2.2 Accelerometer FeaturesThe triple-axis MEMS accelerometer in MPU-6881 includes a wide range of features:∙Digital-output X-, Y-, and Z-axis accelerometer with a programmable full scale range of ±2g, ±4g, ±8g and ±16g and integrated 16-bit ADCs∙Accelerometer normal operating current: 450µA∙Low power accelerometer mode current: 7.27µA at 0.98Hz, 18.65µA at 31.25Hz∙User-programmable interrupts∙Wake-on-motion interrupt for low power operation of applications processor∙Self-test2.3 Additional FeaturesThe MPU-6881 includes the following additional features:∙Auxiliary master I2C bus for reading data from external sensors (e.g. magnetometer)∙ 3.4mA operating current when all 6 motion sensing axes are active∙VDD supply voltage range of 1.8 – 3.3V ± 5%∙VDDIO reference voltage of 1.8 – 3.3V ± 5% for auxiliary I2C devices∙Smallest and thinnest QFN package for portable devices: 3x3x0.9mm (24-pin QFN)∙Minimal cross-axis sensitivity between the accelerometer and gyroscope axes∙4096 byte FIFO buffer enables the applications processor to read the data in bursts∙Digital-output temperature sensor∙User-programmable digital filters for gyroscope, accelerometer, and temp sensor∙10,000 g shock tolerant∙400kHz Fast Mode I2C for communicating with all registers∙1MHz SPI serial interface for communicating with all registers∙20MHz SPI serial interface for reading sensor and interrupt registers∙MEMS structure hermetically sealed and bonded at wafer level∙RoHS and Green compliant3 Electrical Characteristics3.1 Gyroscope SpecificationsTypical Operating Circuit of section 4.2, VDD = 1.8V, VDDIO = 1.8V, T A=25°C, unless otherwise noted.Please refer to the following document for information on Self-Test: MPU-6500 Accelerometer and Gyroscope Self-Test Implementation; AN-MPU-6500A-02.Table 1 Gyroscope SpecificationsNotes:1. Derived from validation or characterization of parts, not guaranteed in production.3.2 Accelerometer SpecificationsTypical Operating Circuit of section 4.2, VDD = 1.8V, VDDIO = 1.8V, T A=25°C, unless otherwise noted.Please refer to the following document for information on Self-Test: MPU-6500 Accelerometer and Gyroscope Self-Test Implementation; AN-MPU-6500A-02.Table 2 Accelerometer SpecificationsNotes:1. Derived from validation or characterization of parts, not guaranteed in production.3.3 Electrical Specifications3.3.1 D.C. Electrical CharacteristicsTypical Operating Circuit of section 4.2, VDD = 1.8V, VDDIO = 1.8V, T A=25°C, unless otherwise noted.Table 3 D.C. Electrical CharacteristicsNotes:1. Derived from validation or characterization of parts, not guaranteed in production.2. Accelerometer Low Power Mode supports the following output data rates (ODRs): 0.24, 0.49, 0.98,1.95, 3.91, 7.81, 15.63, 31.25, 62.50, 125, 250, 500Hz. Supply current for any update rate can becalculated as:a. Supply Current in µA = 6.9 + Update Rate * 0.3763.3.2 A.C. Electrical CharacteristicsTypical Operating Circuit of section 4.2, VDD = 1.8V, VDDIO = 1.8V, T A=25°C, unless otherwise noted.Table 4 A.C. Electrical CharacteristicsNotes:1. Derived from validation or characterization of parts, not guaranteed in production.3.3.3 Other Electrical SpecificationsTypical Operating Circuit of section 4.2, VDD = 1.8V, VDDIO = 1.8V, T A=25°C, unless otherwise noted.Table 5 Other Electrical SpecificationsNotes:1. Derived from validation or characterization of parts, not guaranteed in production.3.4 I2C Timing CharacterizationTypical Operating Circuit of section 4.2, VDD = 1.8V, VDDIO = 1.8V, T A=25°C, unless otherwise noted.Table 6 I2C Timing CharacteristicsNotes:1.Timing Characteristics apply to both Primary and Auxiliary I2C Bus2.Based on characterization of 5 parts over temperature and voltage as mounted on evaluation board or in socketsFigure 1 I2C Bus Timing Diagram3.5 SPI Timing CharacterizationTypical Operating Circuit of section 4.2, VDD = 1.8V, VDDIO = 1.8V, T A=25°C, unless otherwise noted.Table 7 SPI Timing CharacteristicsNotes:3.Based on characterization of 5 parts over temperature and voltage as mounted on evaluation board or in socketsFigure 2 SPI Bus Timing Diagram3.5.1 fSCLK = 20MHzTable 8 fCLK = 20MHzNotes:1.Based on characterization of 5 parts over temperature and voltage as mounted on evaluation board or in sockets3.6 Absolute Maximum RatingsStress above those listed as “Absolute Maximum Ratings” may cause permanent damage to the device. These are stress ratings only and functional operation of the device at these conditions is not implied. Exposure to the absolute maximum ratings conditions for extended periods may affect device reliability.Table 9 Absolute Maximum Ratings4 Applications Information4.1Pin Out Diagram and Signal DescriptionTable 10 Signal DescriptionsA U X _C LV D D I OS D O / A D 0R E G O U TF S Y N CI N TS C L / S C L Kn C SR E S V S D A / S D IA U X _D AR E S VNC NC NC NC NC NCFigure 3 Pin out Diagram for MPU-6881 3.0x3.0x0.9mm QFN4.2Typical Operating Circuit– 3.3VDC m F1.8 –AD0– 3.3VDC m F1.8 –SD0(a)(b)Figure 4 MPU-6881 QFN Application Schematic. (a) I2C operation, (b) SPI operation.4.3Bill of Materials for External Components Table 11 Bill of Materials4.4 Block DiagramVDD GND PLLFILTFigure 5 MPU-6881 Block Diagram4.5 OverviewThe MPU-6881 is comprised of the following key blocks and functions:∙Three-axis MEMS rate gyroscope sensor with 16-bit ADCs and signal conditioning ∙Three-axis MEMS accelerometer sensor with 16-bit ADCs and signal conditioning ∙Primary I2C and SPI serial communications interfaces∙Auxiliary I2C serial interface∙Self-Test∙Clocking∙Sensor Data Registers∙FIFO∙Interrupts∙Digital-Output Temperature Sensor∙Bias and LDOs∙Charge Pump∙Standard Power Modes4.6 Three-Axis MEMS Gyroscope with 16-bit ADCs and Signal ConditioningThe MPU-6881 consists of three independent vibratory MEMS rate gyroscopes, which detect rotation about the X-, Y-, and Z- Axes. When the gyros are rotated about any of the sense axes, the Coriolis Effect causes a vibration that is detected by a capacitive pickoff. The resulting signal is amplified, demodulated, and filtered to produce a voltage that is proportional to the angular rate. This voltage is digitized using individual on-chip 16-bit Analog-to-Digital Converters (ADCs) to sample each axis. The full-scale range of the gyro sensors may be digitally programmed to ±250, ±500, ±1000, or ±2000 degrees per second (dps). The ADC sample rate is programmable from 8,000 samples per second, down to 3.9 samples per second, and user-selectable low-pass filters enable a wide range of cut-off frequencies.4.7 Three-Axis MEMS Accelerometer with 16-bit ADCs and Signal ConditioningThe MPU-6881’s 3-Axis accelerometer uses separate proof masses for each axis. Acceleration along a particular axis induces displacement on the corresponding proof mass, and capacitive sensors detect the displacement differentially. The MPU-6881’s architecture reduces the accelerometers’ susceptibility to fabrication variations as well as to thermal drift. When the device is placed on a flat surface, it will measure 0g on the X- and Y-axes and +1g on the Z-axis. The accelerometer s’ scale factor is calibrated at the factory and is nominally independent of supply voltage. Each sensor has a dedicated sigma-delta ADC for providing digital outputs. The full scale range of the digital output can be adjusted to ±2g, ±4g, ±8g, or ±16g.4.8 I2C and SPI Serial Communications InterfacesThe MPU-6881 communicates to a system processor using either a SPI or an I2C serial interface. The MPU-6881 always acts as a slave when communicating to the system processor. The LSB of the of the I2C slave address is set by pin 4 (AD0).4.8.1 MPU-6881 Solution Using I2C InterfaceIn the figure below, the system processor is an I2C master to the MPU-6881.Figure 6 MPU-6881 Solution Using I2C Interface4.8.2 MPU-6881 Solution Using SPI InterfaceIn the figure below, the system processor is an SPI master to the MPU-6881. Pins 2, 3, 4, and 5 are used to support the SCLK, SDI, SDO, and CS signals for SPI communications.Figure 7 MPU-6881 Solution Using SPI Interface4.9 Self-TestPlease refer to the register map document for more details on self-test.Self-test allows for the testing of the mechanical and electrical portions of the sensors. The self-test for each measurement axis can be activated by means of the gyroscope and accelerometer self-test registers (registers 13 to 16).When the self-test is activated, the electronics cause the sensors to be actuated and produce an output signal. The output signal is used to observe the self-test response.The self-test response is defined as follows:Self-test response = Sensor output with self-test enabled – Sensor output without self-test enabled The self-test response for each gyroscope axis is defined in the gyroscope specification table, while that for each accelerometer axis is defined in the accelerometer specification table.When the value of the self-test response is within the specified min/max limits of the product specification, the part has passed self-test. When the self-test response exceeds the min/max values, the part is deemed to have failed self-test. It is recommended to use InvenSense MotionApps software for executing self-test.4.10 ClockingThe MPU-6881 has a flexible clocking scheme, allowing a variety of internal clock sources to be used for the internal synchronous circuitry. This synchronous circuitry includes the signal conditioning and ADCs, and various control circuits and registers. An on-chip PLL provides flexibility in the allowable inputs for generating this clock.Allowable internal sources for generating the internal clock are:∙An internal relaxation oscillator∙Any of the X, Y, or Z gyros (MEMS oscillators with a variation of ±1% over temperature)Selection of the source for generating the internal synchronous clock depends on the requirements for power consumption and clock accuracy. These requirements will most likely vary by mode of operation.There are also start-up conditions to consider. When the MPU-6881 first starts up, the device uses its internal clock until programmed to operate from another source. This allows the user, for example, to wait for the MEMS oscillators to stabilize before they are selected as the clock source.4.11 Sensor Data RegistersThe sensor data registers contain the latest gyro, accelerometer, auxiliary sensor, and temperature measurement data. They are read-only registers, and are accessed via the serial interface. Data from these registers may be read anytime.4.12 FIFOThe MPU-6881 contains a 4096-byte FIFO register that is accessible via the Serial Interface. The FIFO configuration register determines which data is written into the FIFO. Possible choices include gyro data, accelerometer data, temperature readings, auxiliary sensor readings, and SYNC input. A FIFO counter keeps track of how many bytes of valid data are contained in the FIFO. The FIFO register supports burst reads. The interrupt function may be used to determine when new data is available.For further information regarding the FIFO, please refer to the MPU-6881 Register Map and Register Descriptions document.4.13 InterruptsInterrupt functionality is configured via the Interrupt Configuration register. Items that are configurable include the INT pin configuration, the interrupt latching and clearing method, and triggers for the interrupt. Items that can trigger an interrupt are (1) Clock generator locked to new reference oscillator (used when switching clock sources); (2) new data is available to be read (from the FIFO and Data registers); (3) accelerometer event interrupts; and (4) the MPU-6881 did not receive an acknowledge from an auxiliary sensor on the secondary I2C bus. The interrupt status can be read from the Interrupt Status register.For further information regarding interrupts, please refer to the MPU-6881 Register Map and Register Descriptions document.4.14 Digital-Output Temperature SensorAn on-chip temperature sensor and ADC are used to measure the MPU-6881 die temperature. The readings from the ADC can be read from the FIFO or the Sensor Data registers.4.15 Bias and LDOsThe bias and LDO section generates the internal supply and the reference voltages and currents required by the MPU-6881. Its two inputs are an unregulated VDD and a VDDIO logic reference supply voltage. The LDO output is bypassed by a capacitor at PLLFILT. For further details on the capacitor, please refer to the Bill of Materials for External Components.4.16 Charge PumpAn on-chip charge pump generates the high voltage required for the MEMS oscillators.4.17 Standard Power ModesThe following table lists the user-accessible power modes for MPU-6881.Table 12 Standard Power Modes for MPU-6881Notes:1. Power consumption for individual modes can be found in section 3.3.1.5 Programmable InterruptsThe MPU-6881 has a programmable interrupt system which can generate an interrupt signal on the INT pin. Status flags indicate the source of an interrupt. Interrupt sources may be enabled and disabled individually.Table 13 Table of Interrupt SourcesFor information regarding the interrupt enable/disable registers and flag registers, please refer to the MPU-6881 Register Map and Register Descriptions document. Some interrupt sources are explained below.6 Digital Interface6.1 I2C and SPI Serial InterfacesThe internal registers and memory of the MPU-6881 can be accessed using either I2C at 400 kHz or SPI at 1MHz. SPI operates in four-wire mode.Table 14 Serial InterfaceNote:To prevent switching into I2C mode when using SPI, the I2C interface should be disabled by setting the I2C_IF_DIS configuration bit. Setting this bit should be performed immediately after waiting for the time specified by the “Start-Up Time for Reg ister Read/Write” in Section 6.3.For further information regarding the I2C_IF_DIS bit, please refer to the MPU-6881 Register Map and Register Descriptions document.6.2 I2C InterfaceI2C is a two-wire interface comprised of the signals serial data (SDA) and serial clock (SCL). In general, the lines are open-drain and bi-directional. In a generalized I2C interface implementation, attached devices can be a master or a slave. The master device puts the slave address on the bus, and the slave device with the matching address acknowledges the master.The MPU-6881 always operates as a slave device when communicating to the system processor, which thus acts as the master. SDA and SCL lines typically need pull-up resistors to VDD. The maximum bus speed is 400 kHz.The slave address of the MPU-6881 is b110100X which is 7 bits long. The LSB bit of the 7 bit address is determined by the logic level on pin AD0. This allows two MPU-6881s to be connected to the same I2C bus. When used in this configuration, the address of the one of the devices should be b1101000 (pin AD0 is logic low) and the address of the other should be b1101001 (pin AD0 is logic high).6.3 I2C Communications ProtocolSTART (S) and STOP (P) ConditionsCommunication on the I2C bus starts when the master puts the START condition (S) on the bus, which is defined as a HIGH-to-LOW transition of the SDA line while SCL line is HIGH (see figure below). The bus is considered to be busy until the master puts a STOP condition (P) on the bus, which is defined as a LOW to HIGH transition on the SDA line while SCL is HIGH (see figure below).Additionally, the bus remains busy if a repeated START (Sr) is generated instead of a STOP condition.SDASCLPSSTART condition STOP conditionFigure 8 START and STOP ConditionsData Format / AcknowledgeI2C data bytes are defined to be 8-bits long. There is no restriction to the number of bytes transmitted per data transfer. Each byte transferred must be followed by an acknowledge (ACK) signal. The clock for the acknowledge signal is generated by the master, while the receiver generates the actual acknowledge signal by pulling down SDA and holding it low during the HIGH portion of the acknowledge clock pulse.If a slave is busy and cannot transmit or receive another byte of data until some other task has been performed, it can hold SCL LOW, thus forcing the master into a wait state. Normal data transfer resumes when the slave is ready, and releases the clock line (refer to the following figure).DATA OUTPUT BYTRANSMITTER (SDA)DATA OUTPUT BYRECEIVER (SDA)SCL FROMMASTERSTARTacknowledgementconditionFigure 9 Acknowledge on the I2C BusCommunicationsAfter beginning communications with the START condition (S), the master sends a 7-bit slave addressfollowed by an 8thbit, the read/write bit. The read/write bit indicates whether the master is receiving data from or is writing to the slave device. Then, the master releases the SDA line and waits for the acknowledge signal (ACK) from the slave device. Each byte transferred must be followed by an acknowledge bit. To acknowledge, the slave device pulls the SDA line LOW and keeps it LOW for the high period of the SCL line. Data transmission is always terminated by the master with a STOP condition (P), thus freeing the communications line. However, the master can generate a repeated START condition (Sr), and address another slave without first generating a STOP condition (P). A LOW to HIGH transition on the SDA line while SCL is HIGH defines the stop condition. All SDA changes should take place when SCL is low, with the exception of start and stop conditions.SDASTART conditionSCLADDRESS R/W ACK DATAACK DATA ACKSTOP conditionSP1 – 789 1 – 789 1 – 789Figure 10 Complete I 2C Data TransferTo write the internal MPU-6881 registers, the master transmits the start condition (S), followed by the I 2Caddress and the write bit (0). At the 9thclock cycle (when the clock is high), the MPU-6881 acknowledges the transfer. Then the master puts the register address (RA) on the bus. After the MPU-6881 acknowledges the reception of the register address, the master puts the register data onto the bus. This is followed by the ACK signal, and data transfer may be concluded by the stop condition (P). To write multiple bytes after the last ACK signal, the master can continue outputting data rather than transmitting a stop signal. In this case, the MPU-6881 automatically increments the register address and loads the data to the appropriate register. The following figures show single and two-byte write sequences.Single-Byte Write SequenceBurst Write SequenceTo read the internal MPU-6881 registers, the master sends a start condition, followed by the I2C address and a write bit, and then the register address that is going to be read. Upon receiving the ACK signal from the MPU-6881, the master transmits a start signal followed by the slave address and read bit. As a result, the MPU-6881 sends an ACK signal and the data. The communication ends with a not acknowledge (NACK) signal and a stop bit from master. The NACK condition is defined such that the SDA line remains high at the 9th clock cycle. The following figures show single and two-byte read sequences.Single-Byte Read SequenceBurst Read Sequence6.4 I2C TermsTable 15 I2C Terms6.5 SPI InterfaceSPI is a 4-wire synchronous serial interface that uses two control lines and two data lines. The MPU-6881 always operates as a Slave device during standard Master-Slave SPI operation.With respect to the Master, the Serial Clock output (SCLK), the Serial Data Output (SDO) and the Serial Data Input (SDI) are shared among the Slave devices. Each SPI slave device requires its own Chip Select (CS) line from the master.CS goes low (active) at the start of transmission and goes back high (inactive) at the end. Only one CS line is active at a time, ensuring that only one slave is selected at any given time. The CS lines of the non-selected slave devices are held high, causing their SDO lines to remain in a high-impedance (high-z) state so that they do not interfere with any active devices.SPI Operational Features1. Data is delivered MSB first and LSB last2. Data is latched on the rising edge of SCLK3. Data should be transitioned on the falling edge of SCLK4. The maximum frequency of SCLK is 1MHz5. SPI read and write operations are completed in 16 or more clock cycles (two or more bytes). Thefirst byte contains the SPI Address, and the following byte(s) contain(s) the SPI data. The firstbit of the first byte contains the Read/Write bit and indicates the Read (1) or Write (0) operation.The following 7 bits contain the Register Address. In cases of multiple-byte Read/Writes, data istwo or more bytes:6. Supports Single or Burst Read/Writes.。

幽门螺杆菌检测方法研究新进展邵军丽;吴丰【摘要】In this artical we are mainly from several aspects included culture, rapid urease test, histology examination, urea breath test, antibody detection, stool antigen test and molecular biological detection. The development of detection methods for Helicobacter pylori was reviewed briefly in recent years.%本文就近年来幽门螺杆菌检测方法新进展作一简要的概述,主要从细菌培养、快速尿素酶实验、组织学检查、尿素呼气实验、抗体检测、粪便抗原检测和分子生物学检测等几个方面展开.【期刊名称】《胃肠病学和肝病学杂志》【年(卷),期】2012(021)008【总页数】4页(P691-694)【关键词】幽门螺杆菌;检测方法;快速尿素酶实验;尿素呼气实验【作者】邵军丽;吴丰【作者单位】广东医学院公共卫生学院,广东东莞523808;东莞中学松山湖学校生物科组【正文语种】中文【中图分类】R573幽门螺杆菌(Helicobacter pylori，H.pylori)感染与慢性胃炎、胃溃疡、胃腺癌、胃黏膜相关性淋巴瘤有着密切的联系，在胃炎、胃溃疡、十二指肠溃疡和胃癌患者中H.pylori感染率约90%。

世界卫生组织已把H.pylori列为第一类致癌因子，并明确为胃癌的危险因子。

所以H.pylori感染的早诊断、早治疗十分重要和必要。

H.pylori检测是H.pylori感染诊断的重要手段，本文就H.pylori检测方法近年来的发展作一概述。

一般用脑心浸液(或哥伦比亚琼脂或布氏琼脂)添加一定量的血清或全血，选择性抗生素做培养基，微氧条件培养3～5 d，根据菌落特征、涂片镜检、三酶(尿素酶、氧化酶、过氧化氢酶)试验判定为H.pylori阳性或阴性。