Pub Date : 2019-04-15DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.04.005
Simin Zhou, Man Liu, Lu Zhou, Liping Guo, Yi-xiang Chang
Objective To provide clues for the study on the mechanism of autoimmune liver disease (AILD) by exploring the existence of specific bacteria in liver tissues of AILD patients. Methods From August 2017 to August 2018, at Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, a total of 12 patients diagnosed as AILD (four autoimmune hepatitis (AIH), four primary biliary cirrhosis (PBC) and four PBC-AIH overlap syndrome (OS)) and four patients with hepatic cyst (control group) were enrolled and all the patients underwent liver biopsy. 16S rRNA gene sequencing was carried out in the obtained aseptic liver tissues. Linear discriminant analysis effect size was used to find out the specific bacteria. Spearman correlation analysis was performed to analyze the correlation between the liver microbiota and the disease. The metabolic function of the 16S rRNA gene sequences was also predicted. Results Bacteria were detected in the liver tissues of all the 16 patients. At the species level, the abundance of Planococcus rifietoensis of AIH group was 0.100%, which was higher than those of other three groups (0), and the difference was statistically significant (linear discriminant analysis (LDA)=3.31, P=0.034). The abundance of Anoxybacillus flavithermus of PBC group was 0.200%, which was higher than those of other three groups (0.100%), and the difference was statistically significant (LDA=3.34, P=0.014). The abundance of Pseudomonas aeruginosa PAO1, Bacillus firmus, Brevibacillus agri, Acinetobacter baumannii, Sphingomonas zeae and Salmonella enterica were significantly negatively correlated with serum level of γ-glutamyl transferase (r=-0.68, -0.68, -0.67, -0.68, -0.68 and -0.66, all P<0.01). Compared with that of the hepatic cyst group, the lipid metabolism of AILD patients decreased. The levels of serum low density lipoprotein and total cholesterol were significantly negatively correlated with the biosynthesis of unsaturated fatty acids (r=-0.55 and -0.65, both P<0.05). Conclusions There exist specific bacteria in the liver tissues of AIH and PBC groups. The liver microbiota which is closely related with the pathogenesis of AILD might be a potential therapeutic target and diagnostic biomarker. Key words: Autoimmune liver disease; Liver tissues; 16S rRNA gene sequencing; Microbiota richness; Diversity
{"title":"Preliminary study on abundance and diversity of microbiota in liver tissues of patients with autoimmune liver disease","authors":"Simin Zhou, Man Liu, Lu Zhou, Liping Guo, Yi-xiang Chang","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.04.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.04.005","url":null,"abstract":"Objective \u0000To provide clues for the study on the mechanism of autoimmune liver disease (AILD) by exploring the existence of specific bacteria in liver tissues of AILD patients. \u0000 \u0000 \u0000Methods \u0000From August 2017 to August 2018, at Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, a total of 12 patients diagnosed as AILD (four autoimmune hepatitis (AIH), four primary biliary cirrhosis (PBC) and four PBC-AIH overlap syndrome (OS)) and four patients with hepatic cyst (control group) were enrolled and all the patients underwent liver biopsy. 16S rRNA gene sequencing was carried out in the obtained aseptic liver tissues. Linear discriminant analysis effect size was used to find out the specific bacteria. Spearman correlation analysis was performed to analyze the correlation between the liver microbiota and the disease. The metabolic function of the 16S rRNA gene sequences was also predicted. \u0000 \u0000 \u0000Results \u0000Bacteria were detected in the liver tissues of all the 16 patients. At the species level, the abundance of Planococcus rifietoensis of AIH group was 0.100%, which was higher than those of other three groups (0), and the difference was statistically significant (linear discriminant analysis (LDA)=3.31, P=0.034). The abundance of Anoxybacillus flavithermus of PBC group was 0.200%, which was higher than those of other three groups (0.100%), and the difference was statistically significant (LDA=3.34, P=0.014). The abundance of Pseudomonas aeruginosa PAO1, Bacillus firmus, Brevibacillus agri, Acinetobacter baumannii, Sphingomonas zeae and Salmonella enterica were significantly negatively correlated with serum level of γ-glutamyl transferase (r=-0.68, -0.68, -0.67, -0.68, -0.68 and -0.66, all P<0.01). Compared with that of the hepatic cyst group, the lipid metabolism of AILD patients decreased. The levels of serum low density lipoprotein and total cholesterol were significantly negatively correlated with the biosynthesis of unsaturated fatty acids (r=-0.55 and -0.65, both P<0.05). \u0000 \u0000 \u0000Conclusions \u0000There exist specific bacteria in the liver tissues of AIH and PBC groups. The liver microbiota which is closely related with the pathogenesis of AILD might be a potential therapeutic target and diagnostic biomarker. \u0000 \u0000 \u0000Key words: \u0000Autoimmune liver disease; Liver tissues; 16S rRNA gene sequencing; Microbiota richness; Diversity","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"46 1","pages":"244-250"},"PeriodicalIF":0.0,"publicationDate":"2019-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78163702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-15DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.04.002
Gao-jue Wu, F. Xu, L. Gong, Jiande D. Z. Chen, Lin Lin
Objective To investigate the differences of anorectal manometry (ARM) parameters in different position (left lateral position and seated position) in patients with functional constipation (FC), and the value of rectoanal pressure gradient (RAPG) was assessed in seated position in the evaluation of anorectal motility disorder in patients with FC. Methods From March 2015 to July 2016, at Clinical Gastrointestinal Motility Center of Ningbo Yinzhou People′s Hospital, 66 consecutive patients with FC aged 18 to 75 who met Rome Ⅲ criteria were recruited. The questionnaires of patient assessment of constipation symptom (PAC-SYM) and patient assessment of constipation quality of life (PAC-QoL) were recorded. Patients randomly underwent ARM examination in left lateral or seated positions, and then followed by a balloon expulsion test (BET) in seated position. The differences of ARM parameters in different positions were compared. The correlation between ARM parameters and BET results, constipation symptoms and quality of life scores were analyzed. T-test, Spearman correlation analysis and Kappa coefficient were performed for statistical analysis. Results ARM parameters including rectal resting pressure, rectal defecation pressure and RAPG in seated position were both higher than those of left lateral position ((30.83±7.89) mmHg (1 mmHg=0.133 kPa) vs. (10.53±3.94) mmHg, (78.86±22.25) mmHg vs. (54.92±21.26) mmHg, (17.53±27.40) mmHg vs. (-7.80±26.88) mmHg), and the differences were statistically significant (t=-21.10, -12.35 and -8.84, all P 0.05). The RAPG in seated position was highly consistent with BET, with a maximum Kappa-value of 0.643, which was higher than the maxium Kappa-value of 0.349 in left lateral position. The optimal RAPG threshold of seated position was 10 mmHg, the sensitivity of RAPG in the prediction of BET was 85.71% and the specificity was 79.17%. According to the optimal RAPG threshold in seated position, the patients were divided into high RAPG group and low RAPG group. The frequency of weekly spontaneous defecation of high RAPG group was higher than that of low RAPG group (2.88±2.16 vs. 1.66±0.96), and the difference was statistically significant (t=2.65, P=0.01). The satisfaction score of PAC-QoL questionnaire of high RAPG group was lower than that of low RAPG group (2.05±0.55 vs.2.83±0.78), and the difference was statistically significant (t=-4.72, P<0.01). Conclusion It may be more reasonable to perform ARM in the seated position in FC patients, especially for the RAPG in seated position is better correlated with BET results, constipation symptoms and quality of life scores which may have more clinical value in the evaluation of anorectal motility disorder in FC patients. Key words: Functional constipation; Anorectal manometry; Balloon expulsion test; Rectoanal pressure gradient
{"title":"Value of rectoanal pressure gradient in seated position in evaluation of anorectal motility disorder in patients with constipation","authors":"Gao-jue Wu, F. Xu, L. Gong, Jiande D. Z. Chen, Lin Lin","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.04.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.04.002","url":null,"abstract":"Objective \u0000To investigate the differences of anorectal manometry (ARM) parameters in different position (left lateral position and seated position) in patients with functional constipation (FC), and the value of rectoanal pressure gradient (RAPG) was assessed in seated position in the evaluation of anorectal motility disorder in patients with FC. \u0000 \u0000 \u0000Methods \u0000From March 2015 to July 2016, at Clinical Gastrointestinal Motility Center of Ningbo Yinzhou People′s Hospital, 66 consecutive patients with FC aged 18 to 75 who met Rome Ⅲ criteria were recruited. The questionnaires of patient assessment of constipation symptom (PAC-SYM) and patient assessment of constipation quality of life (PAC-QoL) were recorded. Patients randomly underwent ARM examination in left lateral or seated positions, and then followed by a balloon expulsion test (BET) in seated position. The differences of ARM parameters in different positions were compared. The correlation between ARM parameters and BET results, constipation symptoms and quality of life scores were analyzed. T-test, Spearman correlation analysis and Kappa coefficient were performed for statistical analysis. \u0000 \u0000 \u0000Results \u0000ARM parameters including rectal resting pressure, rectal defecation pressure and RAPG in seated position were both higher than those of left lateral position ((30.83±7.89) mmHg (1 mmHg=0.133 kPa) vs. (10.53±3.94) mmHg, (78.86±22.25) mmHg vs. (54.92±21.26) mmHg, (17.53±27.40) mmHg vs. (-7.80±26.88) mmHg), and the differences were statistically significant (t=-21.10, -12.35 and -8.84, all P 0.05). The RAPG in seated position was highly consistent with BET, with a maximum Kappa-value of 0.643, which was higher than the maxium Kappa-value of 0.349 in left lateral position. The optimal RAPG threshold of seated position was 10 mmHg, the sensitivity of RAPG in the prediction of BET was 85.71% and the specificity was 79.17%. According to the optimal RAPG threshold in seated position, the patients were divided into high RAPG group and low RAPG group. The frequency of weekly spontaneous defecation of high RAPG group was higher than that of low RAPG group (2.88±2.16 vs. 1.66±0.96), and the difference was statistically significant (t=2.65, P=0.01). The satisfaction score of PAC-QoL questionnaire of high RAPG group was lower than that of low RAPG group (2.05±0.55 vs.2.83±0.78), and the difference was statistically significant (t=-4.72, P<0.01). \u0000 \u0000 \u0000Conclusion \u0000It may be more reasonable to perform ARM in the seated position in FC patients, especially for the RAPG in seated position is better correlated with BET results, constipation symptoms and quality of life scores which may have more clinical value in the evaluation of anorectal motility disorder in FC patients. \u0000 \u0000 \u0000Key words: \u0000Functional constipation; Anorectal manometry; Balloon expulsion test; Rectoanal pressure gradient","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"2181 1","pages":"223-228"},"PeriodicalIF":0.0,"publicationDate":"2019-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91387496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-15DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.04.006
C. Hou, Jun Xu, Han Qin, Xian-yang Zhu, Y. Fei
Objective To evaluate the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of patients with hepatic sinusoidal obstruction syndrome (HSOS). Methods From April 2015 to August 2018, at The First Affiliated Hospital of University of Science and Technology of China, 21 patients with gynura segetum caused HSOS were selected. All the patients received TIPS treatment because of unresponsiveness to anticoagulant therapy for at least two weeks. After operation patients were followed up with liver and portal vein Doppler ultrasonography examination, liver and kidney function tests, and survival observation. T test, logistic univariate regression analysis and Cox regression analysis were performed for statistical analysis. Results Among the 21 patients with gynura segetum-related HSOS, 18 patients were in the subacute phase and three patients in the chronic phase. All of them were moderate or severe patients and all successfully underwent TIPS. The postoperative portal vein pressure was (16.71±4.68) cmH2O (1 cmH2O=0.098 kPa), which was lower than that before operation ((41.52±6.27) cmH2O), and the difference was statistically significant (t=16.936, P<0.01). The postoperation portal vein blood flow velocity was (41.52±7.70) cm/s, which was higher than before operation ((11.19±3.29) cm/s), and the difference was statistically significant (t=-15.191, P<0.01). At one month after operation, 15 of 21 patients were clinically cured; among the remaining six patients, four patients were improved and two patients were ineffective (including one patient died). At four months after operation, two patients died, and the remaining 19 patients were clinically cured. At one month after operation, the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil) and serum creatinine were (23.7±16.8) U/L, (33.9±7.4) U/L, (52.7±38.2) μmol/L and (62.7±12.6) μmol/L, respectively, which were lower than those before operation ((60.5±42.4) U/L, (78.4±42.4) U/L, (74.9±38.2) μmol/L and (82.4±19.6) μmol/L, respectively), and the differences were statistically significant (t=3.193, 3.493, 2.378 and 4.519; all P<0.05). The level of albumin was (39.0±3.1) g/L, which was higher than that before operation ((30.9±3.8) g/L), and the difference was statistically significant (t=-10.283, P<0.01). Portal vein thrombosis and preoperative TBil level had predictive value for therapeutic efficacy (both P<0.05). The one-year cumulative survival rate of patients was 90.5%. Preoperative TBil level and hepatic encephalopathy had effects on the prognosis of patients (both P<0.05). Conclusion TIPS is a safe, reliable and effective treatment for patients with subacute and chronic gynura segetum-related HSOS who are not responding to ineffective anticoagulant therapy, which can improve the prognosis and survival rate of the patients. Key words: Hepatic veno-occlusive disease; Portasystemic shunt, transjugular int
{"title":"Efficacy of transjugular intrahepatic portosystemic shunt in the treatment of 21 patients with gynura segetum-related hepatic sinusoidal obstruction syndrome","authors":"C. Hou, Jun Xu, Han Qin, Xian-yang Zhu, Y. Fei","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.04.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.04.006","url":null,"abstract":"Objective \u0000To evaluate the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of patients with hepatic sinusoidal obstruction syndrome (HSOS). \u0000 \u0000 \u0000Methods \u0000From April 2015 to August 2018, at The First Affiliated Hospital of University of Science and Technology of China, 21 patients with gynura segetum caused HSOS were selected. All the patients received TIPS treatment because of unresponsiveness to anticoagulant therapy for at least two weeks. After operation patients were followed up with liver and portal vein Doppler ultrasonography examination, liver and kidney function tests, and survival observation. T test, logistic univariate regression analysis and Cox regression analysis were performed for statistical analysis. \u0000 \u0000 \u0000Results \u0000Among the 21 patients with gynura segetum-related HSOS, 18 patients were in the subacute phase and three patients in the chronic phase. All of them were moderate or severe patients and all successfully underwent TIPS. The postoperative portal vein pressure was (16.71±4.68) cmH2O (1 cmH2O=0.098 kPa), which was lower than that before operation ((41.52±6.27) cmH2O), and the difference was statistically significant (t=16.936, P<0.01). The postoperation portal vein blood flow velocity was (41.52±7.70) cm/s, which was higher than before operation ((11.19±3.29) cm/s), and the difference was statistically significant (t=-15.191, P<0.01). At one month after operation, 15 of 21 patients were clinically cured; among the remaining six patients, four patients were improved and two patients were ineffective (including one patient died). At four months after operation, two patients died, and the remaining 19 patients were clinically cured. At one month after operation, the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil) and serum creatinine were (23.7±16.8) U/L, (33.9±7.4) U/L, (52.7±38.2) μmol/L and (62.7±12.6) μmol/L, respectively, which were lower than those before operation ((60.5±42.4) U/L, (78.4±42.4) U/L, (74.9±38.2) μmol/L and (82.4±19.6) μmol/L, respectively), and the differences were statistically significant (t=3.193, 3.493, 2.378 and 4.519; all P<0.05). The level of albumin was (39.0±3.1) g/L, which was higher than that before operation ((30.9±3.8) g/L), and the difference was statistically significant (t=-10.283, P<0.01). Portal vein thrombosis and preoperative TBil level had predictive value for therapeutic efficacy (both P<0.05). The one-year cumulative survival rate of patients was 90.5%. Preoperative TBil level and hepatic encephalopathy had effects on the prognosis of patients (both P<0.05). \u0000 \u0000 \u0000Conclusion \u0000TIPS is a safe, reliable and effective treatment for patients with subacute and chronic gynura segetum-related HSOS who are not responding to ineffective anticoagulant therapy, which can improve the prognosis and survival rate of the patients. \u0000 \u0000 \u0000Key words: \u0000Hepatic veno-occlusive disease; Portasystemic shunt, transjugular int","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"66 1","pages":"251-256"},"PeriodicalIF":0.0,"publicationDate":"2019-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75041930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-15DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.03.007
Shuoru Wu, Jing Xia, Yan Xu, Lei Zhang, Huan Wang, W. Qian, Jun Song, T. Bai, Qing-hua Wu, X. Hou
Objective To investigate the improvement of symptoms of the patients after treatment in patients with Rome Ⅳ or non-Rome Ⅳ irritable bowel syndrome (IBS), and to explore the influence of IBS diagnosed by different criteria on the patients. Methods From June 2nd to 8th in 2016, at Outpatients Department of Gastroenterology, Union Hospital Affiliated to Tongji Medical College, Huazhong Uiversity of Science and Technology in Wuhan, 1 500 outpatients aged over 18 years old and with intestinal symptom were selected for questionnaire. After treatment for six months, IBS patients, non-IBS patients, patients with Rome Ⅳ IBS and patients with non-Rome Ⅳ IBS were followed up by phone calls. After treatment, the improvement of symptoms of the patients was evaluated by irritable bowel syndrome symptom severity scale (IBS-SSS). The degree of influence of IBS diagnosed with different criteria on patients was evaluated by the patient′s daily work whether to choose colonoscopy examination, whether to choose medication, and the efficacy of medicine. Student′s t test, Mann-Whitney U test and chi-square test were performed for statistical analysis. Results A total of 352 patients with intestinal symptoms were followed-up, including 175 patients with IBS (84 patients with Rome Ⅳ IBS and 91 patients with non-Rome Ⅳ IBS) and 177 non-IBS patients, and 142 patients responded. There were no statistically significant differences in response rate between non-IBS patients and IBS patients (37.3%, 66/177 vs. 43.4%, 76/175), and between patients with Rome Ⅳ IBS and patients with non-Rome Ⅳ IBS (40.5%, 34/84 vs. 46.2%, 42/91) (χ2=1.379 and 0.573, P=0.240 and 0.449). Compared with the non-IBS patients, the degree of satisfaction of medicine was lower in IBS patients (71.4%, 30/42 vs. 47.5%, 19/40). Compared with non-Rome Ⅳ IBS patients, Rome type Ⅳ IBS patients were more likely to receive colonoscopy (35.7%, 15/42 vs. 58.8%, 20/34), and the differences were statistically significant (χ2=4.878 and 4.039, P=0.027 and 0.044). After six months of treatment, symptoms improved in both Rome Ⅳ IBS patients and non-Rome Ⅳ IBS patients (both P<0.05), however, the symptoms improved more significantly in Rome Ⅳ IBS patients and the total score of IBS-SSS was lower than that of non-Rome Ⅳ IBS patients (-130, -185 to 60 vs. -70, -100 to 28), and the difference was statistically significant (Z=-3.065, P=0.002). The difference was mainly showed the symptom of abdominal pain, and the IBS-SSS abdominal pain score of Rome Ⅳ IBS patients was lower than that of non-Rome Ⅳ IBS patients (-80, -100 to -40 vs. 0, -40 to 0), and the difference was statistically significant (Z=-4.631, P<0.01). Conclusions IBS symptoms influence a lot on the satisfaction degree of treatment in outpatients. Even with similar good therapeutic effects, the Rome Ⅳ IBS symptoms have a more severe impact on patients than non-Rome Ⅳ IBS symptoms. Key words: Irritable bowel syndrome; Diagnosis; Rome type
{"title":"Influence of Rome IV diagnostic criteria on patients with irritable bowel syndrome","authors":"Shuoru Wu, Jing Xia, Yan Xu, Lei Zhang, Huan Wang, W. Qian, Jun Song, T. Bai, Qing-hua Wu, X. Hou","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.03.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.03.007","url":null,"abstract":"Objective \u0000To investigate the improvement of symptoms of the patients after treatment in patients with Rome Ⅳ or non-Rome Ⅳ irritable bowel syndrome (IBS), and to explore the influence of IBS diagnosed by different criteria on the patients. \u0000 \u0000 \u0000Methods \u0000From June 2nd to 8th in 2016, at Outpatients Department of Gastroenterology, Union Hospital Affiliated to Tongji Medical College, Huazhong Uiversity of Science and Technology in Wuhan, 1 500 outpatients aged over 18 years old and with intestinal symptom were selected for questionnaire. After treatment for six months, IBS patients, non-IBS patients, patients with Rome Ⅳ IBS and patients with non-Rome Ⅳ IBS were followed up by phone calls. After treatment, the improvement of symptoms of the patients was evaluated by irritable bowel syndrome symptom severity scale (IBS-SSS). The degree of influence of IBS diagnosed with different criteria on patients was evaluated by the patient′s daily work whether to choose colonoscopy examination, whether to choose medication, and the efficacy of medicine. Student′s t test, Mann-Whitney U test and chi-square test were performed for statistical analysis. \u0000 \u0000 \u0000Results \u0000A total of 352 patients with intestinal symptoms were followed-up, including 175 patients with IBS (84 patients with Rome Ⅳ IBS and 91 patients with non-Rome Ⅳ IBS) and 177 non-IBS patients, and 142 patients responded. There were no statistically significant differences in response rate between non-IBS patients and IBS patients (37.3%, 66/177 vs. 43.4%, 76/175), and between patients with Rome Ⅳ IBS and patients with non-Rome Ⅳ IBS (40.5%, 34/84 vs. 46.2%, 42/91) (χ2=1.379 and 0.573, P=0.240 and 0.449). Compared with the non-IBS patients, the degree of satisfaction of medicine was lower in IBS patients (71.4%, 30/42 vs. 47.5%, 19/40). Compared with non-Rome Ⅳ IBS patients, Rome type Ⅳ IBS patients were more likely to receive colonoscopy (35.7%, 15/42 vs. 58.8%, 20/34), and the differences were statistically significant (χ2=4.878 and 4.039, P=0.027 and 0.044). After six months of treatment, symptoms improved in both Rome Ⅳ IBS patients and non-Rome Ⅳ IBS patients (both P<0.05), however, the symptoms improved more significantly in Rome Ⅳ IBS patients and the total score of IBS-SSS was lower than that of non-Rome Ⅳ IBS patients (-130, -185 to 60 vs. -70, -100 to 28), and the difference was statistically significant (Z=-3.065, P=0.002). The difference was mainly showed the symptom of abdominal pain, and the IBS-SSS abdominal pain score of Rome Ⅳ IBS patients was lower than that of non-Rome Ⅳ IBS patients (-80, -100 to -40 vs. 0, -40 to 0), and the difference was statistically significant (Z=-4.631, P<0.01). \u0000 \u0000 \u0000Conclusions \u0000IBS symptoms influence a lot on the satisfaction degree of treatment in outpatients. Even with similar good therapeutic effects, the Rome Ⅳ IBS symptoms have a more severe impact on patients than non-Rome Ⅳ IBS symptoms. \u0000 \u0000 \u0000Key words: \u0000Irritable bowel syndrome; Diagnosis; Rome type ","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"161 1","pages":"167-172"},"PeriodicalIF":0.0,"publicationDate":"2019-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80192500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-15DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.03.009
Xuan Yang, Guirong Sun, Qiang Xi, Chong Peng, Lin Wang, Mingjun Liu, Z. Tian
Objective To evaluate the clinical application value of serum high sensitive α-fetoprotein variant ratio (hs-AFP-L3%) in the diagnosis and treatment of hepatocellular carcinoma. Methods From October 2016 to March 2018, at Affiliated Hospital of Qingdao University, 160 patients diagnosed with hepatocellular carcinoma, 32 patients with intrahepatic cholangiocarcinoma (ICC), 52 patients with post-hepatitis B liver cirrhosis, 53 patients with chronic hepatitis B and 50 healthy controls were enrolled. The serum levels of hs-AFP-L3% and α-fetoprotein were measured. Mann-Whitney U test, Spearman correlation analysis, Wilcoxon signed rank test and chi-square test were performed for statistical analysis. Results The serum levels of hs-AFP-L3% and α-fetoprotein in hepatocellular carcinoma group were 24.90% (4.68% to 61.85%) and 113.45 μg/L (11.18 μg/L to 1 803.48 μg/L), respectively, which were higher than those in ICC group (0.50%, 0.50% to 0.50%; and 2.79 μg/L, 1.72 μg/L to 4.04 μg/L), cirrhosis group (0.50%, 0.50% to 5.25%; and 18.35 μg/L, 3.95 μg/L to 31.93 μg/L), chronic hepatitis group (0.50%, 0.50% to 4.25%; and 2.70 μg/L, 1.80 μg/L to 17.00 μg/L), and healthy control group (0.50%, 0.50% to 0.50%; and 1.94 μg/L, 1.46 μg/L to 2.63 μg/L), and the differences were statistically significant (U=461.00, 1 485.50, 1 141.00, 625.00; 401.50, 2 207.00, 1 254.00, 266.00; all P 0.05). The sensitivity of the combined detection was 82.5%, which was higher than that of the separate detection, and the differences were statistically significant (χ2=24.04 and 18.05, both P 0.05). The sensitivity of hs-AFP-L3% in the diagnosis of patients with α-fetoprotein-negative (α-fetoprotein 0.05). Conclusions The sensitivity of hs-AFP-L3% is similar to that of α-fetoprotein in the diagnosis of hepatocellular carcinoma, while the specificity of hs-AFP-L3% is higher than that of α-fetoprotein. The combined detection of the two markers can improve the diagnostic rate of hepatocellular carcinoma. The hs-AFP-L3% has a high diagnostic value in α-fetoprotein-negative hepatocellular carcinoma. Key words: Alpha-fetoprotein; Carcinoma, hepatocellular; Fluorescent antibody technique; Variant
{"title":"Clinical application of highly sensitive α-fetoprotein variant ratio in the diagnosis and treatment of hepatocellular carcinoma","authors":"Xuan Yang, Guirong Sun, Qiang Xi, Chong Peng, Lin Wang, Mingjun Liu, Z. Tian","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.03.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.03.009","url":null,"abstract":"Objective \u0000To evaluate the clinical application value of serum high sensitive α-fetoprotein variant ratio (hs-AFP-L3%) in the diagnosis and treatment of hepatocellular carcinoma. \u0000 \u0000 \u0000Methods \u0000From October 2016 to March 2018, at Affiliated Hospital of Qingdao University, 160 patients diagnosed with hepatocellular carcinoma, 32 patients with intrahepatic cholangiocarcinoma (ICC), 52 patients with post-hepatitis B liver cirrhosis, 53 patients with chronic hepatitis B and 50 healthy controls were enrolled. The serum levels of hs-AFP-L3% and α-fetoprotein were measured. Mann-Whitney U test, Spearman correlation analysis, Wilcoxon signed rank test and chi-square test were performed for statistical analysis. \u0000 \u0000 \u0000Results \u0000The serum levels of hs-AFP-L3% and α-fetoprotein in hepatocellular carcinoma group were 24.90% (4.68% to 61.85%) and 113.45 μg/L (11.18 μg/L to 1 803.48 μg/L), respectively, which were higher than those in ICC group (0.50%, 0.50% to 0.50%; and 2.79 μg/L, 1.72 μg/L to 4.04 μg/L), cirrhosis group (0.50%, 0.50% to 5.25%; and 18.35 μg/L, 3.95 μg/L to 31.93 μg/L), chronic hepatitis group (0.50%, 0.50% to 4.25%; and 2.70 μg/L, 1.80 μg/L to 17.00 μg/L), and healthy control group (0.50%, 0.50% to 0.50%; and 1.94 μg/L, 1.46 μg/L to 2.63 μg/L), and the differences were statistically significant (U=461.00, 1 485.50, 1 141.00, 625.00; 401.50, 2 207.00, 1 254.00, 266.00; all P 0.05). The sensitivity of the combined detection was 82.5%, which was higher than that of the separate detection, and the differences were statistically significant (χ2=24.04 and 18.05, both P 0.05). The sensitivity of hs-AFP-L3% in the diagnosis of patients with α-fetoprotein-negative (α-fetoprotein 0.05). \u0000 \u0000 \u0000Conclusions \u0000The sensitivity of hs-AFP-L3% is similar to that of α-fetoprotein in the diagnosis of hepatocellular carcinoma, while the specificity of hs-AFP-L3% is higher than that of α-fetoprotein. The combined detection of the two markers can improve the diagnostic rate of hepatocellular carcinoma. The hs-AFP-L3% has a high diagnostic value in α-fetoprotein-negative hepatocellular carcinoma. \u0000 \u0000 \u0000Key words: \u0000Alpha-fetoprotein; Carcinoma, hepatocellular; Fluorescent antibody technique; Variant","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"4 1","pages":"181-186"},"PeriodicalIF":0.0,"publicationDate":"2019-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89105172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To explore the pathologic features and distribution characteristics of upper gastrointestinal submucosal tumors (SMT). Methods From January 2013 to December 2017, at Department of Gastroenterology of Taizhou Hospital Affiliated to Wenzhou Medical University, clinical data of 1 182 hospitalized patients with 1 237 upper gastrointestinal SMT who underwent endoscopic therapy and diagnosed by pathology and immunohistochemistry was retrospectively analyzed including the pathological types, tumor of locations, endoscopic findings, layer of origin and tumor size. Results There were 473 esophageal SMT, including 387(81.8%) leiomyomas, located in the mucosal muscularis or muscularis propria; and 59(12.5%) cysts located in the submucosa or mucosal muscularis. There were 138(29.2%) lesions, 159(33.6%) lesions and 176(37.2%) lesions in the upper, middle and lower esophagus respectively, and the most common type was leiomyoma. A total of 723 tumors were gastric SMT, among them 284(39.3%) lesions were gastrointestinal stromal tumors (GIST) and 273(37.8%) lesions were leiomyomas, and all located in the muscularis propria. A total of 69(9.5%) lesions located at cardia, the common types were leiomyoma (55 lesions, 79.7%) and GIST (nine lesions, 13.0%). A total of 239 (33.1%) lesions located at gastric fundus, the common types were GIST (152 lesions, 63.6%) and leiomyoma (79 lesions, 33.1%). A total of 280(38.7%) lesions located at gastric body, the common types were leiomyoma (138 lesions, 49.3%) and GIST (111 lesions, 39.6%). A total of 127(17.6%) lesions located at gastric antrum, the common types were heterotopic pancrease (71 lesions, 55.9%) and lipoma (26 lesions, 20.5%), and all were located in the submucosa, some involved the muscularis propria. There were six (0.8%) lesions at gastric angle, and two (0.3%) at gastrointestinal anastomosis. Forty-one lesions were duodenal SMT, among them 23(56.1%) located at duodenal bulb, the common types were cyst (10 lesions, 43.5%), lipoma (five lesions, 21.7%) and heterotopic pancrease (five lesions, 21.7%). A total of 18(43.9%) lesions located at descending duodenum, the common types were lipoma (nine lesions, 50.0%) and cyst (five lesions, 27.8%), and all lesions located in the submucosa. Conclusions The most common type of SMT in the esophagus and cardia is leiomyoma, however the SMT in gastric fundus and body are mostly leiomyomas and GIST, while in gastric antrum, most SMT are heterotopic pancreases and lipomas. In duodenal bulb and descending duodenum, the common types of SMT are cyst and lipoma. Key words: Leiomyoma; Gastrointestinal stromal tumors; Endosonography; Upper gastrointestinal submucosal tumors; Pathological characteristics; Locations
{"title":"Analysis of pathological features and distribution characteristics of 1237 upper gastrointestinal submucosal tumors","authors":"Jin-Bang Peng, Li-Ping Ye, Xinli Mao, Qin Huang, Jinshun Zhang, Xian-Bin Zhou, Bi-Li He, Jinming Wu","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.02.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.02.004","url":null,"abstract":"Objective \u0000To explore the pathologic features and distribution characteristics of upper gastrointestinal submucosal tumors (SMT). \u0000 \u0000 \u0000Methods \u0000From January 2013 to December 2017, at Department of Gastroenterology of Taizhou Hospital Affiliated to Wenzhou Medical University, clinical data of 1 182 hospitalized patients with 1 237 upper gastrointestinal SMT who underwent endoscopic therapy and diagnosed by pathology and immunohistochemistry was retrospectively analyzed including the pathological types, tumor of locations, endoscopic findings, layer of origin and tumor size. \u0000 \u0000 \u0000Results \u0000There were 473 esophageal SMT, including 387(81.8%) leiomyomas, located in the mucosal muscularis or muscularis propria; and 59(12.5%) cysts located in the submucosa or mucosal muscularis. There were 138(29.2%) lesions, 159(33.6%) lesions and 176(37.2%) lesions in the upper, middle and lower esophagus respectively, and the most common type was leiomyoma. A total of 723 tumors were gastric SMT, among them 284(39.3%) lesions were gastrointestinal stromal tumors (GIST) and 273(37.8%) lesions were leiomyomas, and all located in the muscularis propria. A total of 69(9.5%) lesions located at cardia, the common types were leiomyoma (55 lesions, 79.7%) and GIST (nine lesions, 13.0%). A total of 239 (33.1%) lesions located at gastric fundus, the common types were GIST (152 lesions, 63.6%) and leiomyoma (79 lesions, 33.1%). A total of 280(38.7%) lesions located at gastric body, the common types were leiomyoma (138 lesions, 49.3%) and GIST (111 lesions, 39.6%). A total of 127(17.6%) lesions located at gastric antrum, the common types were heterotopic pancrease (71 lesions, 55.9%) and lipoma (26 lesions, 20.5%), and all were located in the submucosa, some involved the muscularis propria. There were six (0.8%) lesions at gastric angle, and two (0.3%) at gastrointestinal anastomosis. Forty-one lesions were duodenal SMT, among them 23(56.1%) located at duodenal bulb, the common types were cyst (10 lesions, 43.5%), lipoma (five lesions, 21.7%) and heterotopic pancrease (five lesions, 21.7%). A total of 18(43.9%) lesions located at descending duodenum, the common types were lipoma (nine lesions, 50.0%) and cyst (five lesions, 27.8%), and all lesions located in the submucosa. \u0000 \u0000 \u0000Conclusions \u0000The most common type of SMT in the esophagus and cardia is leiomyoma, however the SMT in gastric fundus and body are mostly leiomyomas and GIST, while in gastric antrum, most SMT are heterotopic pancreases and lipomas. In duodenal bulb and descending duodenum, the common types of SMT are cyst and lipoma. \u0000 \u0000 \u0000Key words: \u0000Leiomyoma; Gastrointestinal stromal tumors; Endosonography; Upper gastrointestinal submucosal tumors; Pathological characteristics; Locations","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"13 1","pages":"94-99"},"PeriodicalIF":0.0,"publicationDate":"2019-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83329222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To explore the differences in the prognosis of patients with different immunophenotypes gastrointestinal diffuse large B-cell lymphoma (GI-DLBCL) who received different treatment strategies. Methods From March 2006 to January 2016, at Nanfang Hospital, Southern Medical University in Guangzhou, the clinical data of 99 patients with pathologically confirmed GI-DLBCL were retrospectively analyzed. According to treatment strategies, patients were divided into chemotherapy alone group and combination of surgery and chemotherapy group. According to immunophenotypes, patients were divided into germinal center B-cell-like (GCB) type and non-GCB type. The two-year progression-free survival (PFS) rate and overall survival (OS) rate were evaluated. Kaplan-Meier analysis, log-rank test and Cox regression were performed for statistical analysis. Results Among the 99 patients with GI-DLBCL, 51 patients were treated with chemotherapy alone, and 48 patients were treated with combination of surgery and chemotherapy. Forty-one cases were GCB phenotype and 40 cases were non-GCB phenotype. The median follow-up time was 25 months. The two-year PFS and OS rates were 70.9% and 89.5%, respectively. The two-year PFS and OS rates of chemotherapy alone group were 63.6% and 85.0%, respectively; both were lower than those of combination of surgery and chemotherapy group (79.4% and 94.7%), and the differences were statistically significant (χ2=4.232, P=0.040 and χ2=4.260, P=0.039). The two-year PFS and OS rates of GCB group were 68.8% and 93.9%, respectively. And the two-year PFS and OS rates of non-GCB group were 73.2% and 85.6%, respectively. There were no statistically significant differences between these two groups (both P>0.05). Among 41 patients with GCB type, 25 were treated with combination of surgery and chemotherapy and 16 were treated with chemotherapy alone. The two-year PFS rate of patients treated with combination of surgery and chemotherapy (83.1%) was higher than that of patients treated with chemotherapy alone (49.2%), and the difference was statistically significant (χ2=5.627, P=0.018). The results of multivariate analysis indicated that treatment strategy was not an independent prognostic factor for all the enrolled patients and in patients with GCB type (all P>0.05). Conclusions Immunophenotypes may lack evaluation value of prognosis in patients with GI-DLBCL. Although among all the enrolled patients and patients with GCB type, the prognosis of patients treated with combination of surgery and chemotherapy is better than that of patients treated with chemotherapy alone, treatment strategy is not an independent prognostic factor. Multi-factors should be evaluated before selection of treatment strategy. Key words: Gastrointestinal tract; Lymphoma, large B-cell, diffuse; Surgery; Chemotherapy; Prognosis
{"title":"Correlation between the immunophenotypes, treatment strategies and prognosis of gastrointestinal diffuse large B-cell lymphoma","authors":"Maoqing Jiang, X. Ruan, Ping Chen, Wenlan Zhou, Hubing Wu, Quanshi Wang","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.02.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.02.003","url":null,"abstract":"Objective \u0000To explore the differences in the prognosis of patients with different immunophenotypes gastrointestinal diffuse large B-cell lymphoma (GI-DLBCL) who received different treatment strategies. \u0000 \u0000 \u0000Methods \u0000From March 2006 to January 2016, at Nanfang Hospital, Southern Medical University in Guangzhou, the clinical data of 99 patients with pathologically confirmed GI-DLBCL were retrospectively analyzed. According to treatment strategies, patients were divided into chemotherapy alone group and combination of surgery and chemotherapy group. According to immunophenotypes, patients were divided into germinal center B-cell-like (GCB) type and non-GCB type. The two-year progression-free survival (PFS) rate and overall survival (OS) rate were evaluated. Kaplan-Meier analysis, log-rank test and Cox regression were performed for statistical analysis. \u0000 \u0000 \u0000Results \u0000Among the 99 patients with GI-DLBCL, 51 patients were treated with chemotherapy alone, and 48 patients were treated with combination of surgery and chemotherapy. Forty-one cases were GCB phenotype and 40 cases were non-GCB phenotype. The median follow-up time was 25 months. The two-year PFS and OS rates were 70.9% and 89.5%, respectively. The two-year PFS and OS rates of chemotherapy alone group were 63.6% and 85.0%, respectively; both were lower than those of combination of surgery and chemotherapy group (79.4% and 94.7%), and the differences were statistically significant (χ2=4.232, P=0.040 and χ2=4.260, P=0.039). The two-year PFS and OS rates of GCB group were 68.8% and 93.9%, respectively. And the two-year PFS and OS rates of non-GCB group were 73.2% and 85.6%, respectively. There were no statistically significant differences between these two groups (both P>0.05). Among 41 patients with GCB type, 25 were treated with combination of surgery and chemotherapy and 16 were treated with chemotherapy alone. The two-year PFS rate of patients treated with combination of surgery and chemotherapy (83.1%) was higher than that of patients treated with chemotherapy alone (49.2%), and the difference was statistically significant (χ2=5.627, P=0.018). The results of multivariate analysis indicated that treatment strategy was not an independent prognostic factor for all the enrolled patients and in patients with GCB type (all P>0.05). \u0000 \u0000 \u0000Conclusions \u0000Immunophenotypes may lack evaluation value of prognosis in patients with GI-DLBCL. Although among all the enrolled patients and patients with GCB type, the prognosis of patients treated with combination of surgery and chemotherapy is better than that of patients treated with chemotherapy alone, treatment strategy is not an independent prognostic factor. Multi-factors should be evaluated before selection of treatment strategy. \u0000 \u0000 \u0000Key words: \u0000Gastrointestinal tract; Lymphoma, large B-cell, diffuse; Surgery; Chemotherapy; Prognosis","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"26 1","pages":"88-93"},"PeriodicalIF":0.0,"publicationDate":"2019-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85235652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-15DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.02.006
Yong Lin, Yuan He, J. Zhao, Y. Nie, Yongjian Zhou, Yuyuan Li
Objective To explore the detection rate of colorectal polyps and colorectal cancer under colonoscopy, and their clinicopathological characteristics and changing trend. Methods From January 1, 1991 to December 31, 2017, at Guangzhou First People′s Hospital, the colorectal polyps and colorectal cancer diagnosed by colonoscopy were collected. The gender, age, location of colorectal polyps and colorectal cancer and pathological type were retrospectively analyzed. Chi-square test was performed for statistical analysis. Results Among 77 978 patients underwent routine colonoscope examination, male and female accounted for 50.18% (39 132/77 978) and 49.82% (38 846/77 978), respectively; and the age was (52.8±15.7) years. A total of 23 240 patients with colorectal polyps were detected, and the total detection rate was 29.80%. The detection rate of colorectal polyps of male patients was higher than that of female patients (35.11%, 13 741/39 132 vs. 24.45%, 9 499/38 846), and the difference was statistically significant (χ2=1 059.16, P 0.05); while moderately differentiated adenocarcinoma increased, however, the highly and poorly differentiated type decreased (χ2=249.27, P 0.05). Conclusions The detection rate of colorectal polyps increased in the past 27 years, while colorectal cancer decreased. The elderly men are susceptible populations. The most common location of colorectal polyps and cancer are left colon, which should be carefully examined during colonoscope examination. Key words: Colorectal neoplasms; Colonoscopy; Pathology; Colorectal polyps
{"title":"Analysis of clinicopathological characteristics and changing trend of 77 978 cases of colorectal polyps and colorectal cancer detected by colonoscopy in the past 27 years","authors":"Yong Lin, Yuan He, J. Zhao, Y. Nie, Yongjian Zhou, Yuyuan Li","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.02.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.02.006","url":null,"abstract":"Objective \u0000To explore the detection rate of colorectal polyps and colorectal cancer under colonoscopy, and their clinicopathological characteristics and changing trend. \u0000 \u0000 \u0000Methods \u0000From January 1, 1991 to December 31, 2017, at Guangzhou First People′s Hospital, the colorectal polyps and colorectal cancer diagnosed by colonoscopy were collected. The gender, age, location of colorectal polyps and colorectal cancer and pathological type were retrospectively analyzed. Chi-square test was performed for statistical analysis. \u0000 \u0000 \u0000Results \u0000Among 77 978 patients underwent routine colonoscope examination, male and female accounted for 50.18% (39 132/77 978) and 49.82% (38 846/77 978), respectively; and the age was (52.8±15.7) years. A total of 23 240 patients with colorectal polyps were detected, and the total detection rate was 29.80%. The detection rate of colorectal polyps of male patients was higher than that of female patients (35.11%, 13 741/39 132 vs. 24.45%, 9 499/38 846), and the difference was statistically significant (χ2=1 059.16, P 0.05); while moderately differentiated adenocarcinoma increased, however, the highly and poorly differentiated type decreased (χ2=249.27, P 0.05). \u0000 \u0000 \u0000Conclusions \u0000The detection rate of colorectal polyps increased in the past 27 years, while colorectal cancer decreased. The elderly men are susceptible populations. The most common location of colorectal polyps and cancer are left colon, which should be carefully examined during colonoscope examination. \u0000 \u0000 \u0000Key words: \u0000Colorectal neoplasms; Colonoscopy; Pathology; Colorectal polyps","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"73 1","pages":"106-110"},"PeriodicalIF":0.0,"publicationDate":"2019-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82669278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-15DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.02.007
Guanyi Liao
Objective To explore the clinical manifestation, treatment and prognosis of patients with acute superior mesenteric artery embolism (ASMAE). Methods From October 2012 to March 2018, the clinical data of 66 patients with ASMAE who were admitted to The First Affiliated Hospital of Chongqing Medical University were collected and retrospectively analyzed. The patients were divided into the death group and the survival group according to whether they died during hospitalization. The clinical features, the time of diagnosis and treatment methods of two groups were compared. T-test and chi-square test were performed for statistical analysis. Results Among 66 ASMAE patients, 16 were in the death group and 50 in the survival group. The age of the death group was (75.6±9.9) years, which was greater than that of the survival group ((68.1±13.2) years), and the difference was statistically significant (t=1.998, P=0.041). Among 16 dead patients, the case numbers of diagnosis time less than six hours, complicated with atrial fibrillation, peritoneal irritation sign, weakened or disappeared bowel sounds and complicated with systemic inflammatory response syndrome were 0, 14, 9, 9 and 16, respectively. However, among 50 survival patients, the case numbers of diagnosis time less than six hours, complicated with atrial fibrillation, peritoneal irritation sign, weakened or disappeared bowel sounds and complicated with systemic inflammatory response syndrome were 15 (30.0%), 30 (60.0%), 14 (28.0%), 14 (28.0%) and 36 (72.0%), respectively. The differences between two groups were all statistically significant (χ2=4.621, 4.125, 4.261, 4.261 and 4.134, all P<0.05). Conclusions When sudden severe abdominal pain occurs in elderly patients with atrial fibrillation, ASMAE should be alerted. Early (less than six hours) and correct diagnosis can improve the prognosis of the ASMAE patients. Key words: Atrial fibrillation; Risk factors; Mortality; Superior mesenteric artery embolism
{"title":"Clinical analysis of 66 cases of acute superior mesenteric artery embolism confirmed by surgery and angiography","authors":"Guanyi Liao","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.02.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.02.007","url":null,"abstract":"Objective \u0000To explore the clinical manifestation, treatment and prognosis of patients with acute superior mesenteric artery embolism (ASMAE). \u0000 \u0000 \u0000Methods \u0000From October 2012 to March 2018, the clinical data of 66 patients with ASMAE who were admitted to The First Affiliated Hospital of Chongqing Medical University were collected and retrospectively analyzed. The patients were divided into the death group and the survival group according to whether they died during hospitalization. The clinical features, the time of diagnosis and treatment methods of two groups were compared. T-test and chi-square test were performed for statistical analysis. \u0000 \u0000 \u0000Results \u0000Among 66 ASMAE patients, 16 were in the death group and 50 in the survival group. The age of the death group was (75.6±9.9) years, which was greater than that of the survival group ((68.1±13.2) years), and the difference was statistically significant (t=1.998, P=0.041). Among 16 dead patients, the case numbers of diagnosis time less than six hours, complicated with atrial fibrillation, peritoneal irritation sign, weakened or disappeared bowel sounds and complicated with systemic inflammatory response syndrome were 0, 14, 9, 9 and 16, respectively. However, among 50 survival patients, the case numbers of diagnosis time less than six hours, complicated with atrial fibrillation, peritoneal irritation sign, weakened or disappeared bowel sounds and complicated with systemic inflammatory response syndrome were 15 (30.0%), 30 (60.0%), 14 (28.0%), 14 (28.0%) and 36 (72.0%), respectively. The differences between two groups were all statistically significant (χ2=4.621, 4.125, 4.261, 4.261 and 4.134, all P<0.05). \u0000 \u0000 \u0000Conclusions \u0000When sudden severe abdominal pain occurs in elderly patients with atrial fibrillation, ASMAE should be alerted. Early (less than six hours) and correct diagnosis can improve the prognosis of the ASMAE patients. \u0000 \u0000 \u0000Key words: \u0000Atrial fibrillation; Risk factors; Mortality; Superior mesenteric artery embolism","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"10 1","pages":"111-114"},"PeriodicalIF":0.0,"publicationDate":"2019-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84417605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-15DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.02.005
Yanqin Wang, Li-xia Liu
Objective To observe the expression of insulin-like growth factor binding protein-related protein 1(IGFBPrP1) in human pancreatic tumor tissues and investigate its significance and relationship with clinic pathological characteristics and tumor microenvironment of the pancreatic neoplasms. Methods A total of 236 patients with surgically resected pancreatic tissue from January 2007 to December 2017 were selected from the First Hospital of Shanxi Medical University. Totally 236 patients were divided into paracancer control group (normal pancreatic tissue adjacent to the tumor, n=111), benign group (benign or low-grade malignant tumor such as solid pseudopapillary tumor, n=37), and malignant group (malignant tumors such as pancreatic ductal adenocarcinoma, n=88). The histomorphology and collagen deposition were observed using hematoxylin-eosin (H-E) staining and Sirius red staining in the three groups. The expressions of IGFBPrP1, transforming growth factor β1 (TGFβ1), α-smooth muscle actin (α-SMA)and collagen type Ⅰ of pancreatic tissues in the three groups were detected by immunohistochemical staining. The relationship between IGFBPrP1 and TGFβ1, α-SMA or collagen type Ⅰ, and the relathionship between IGFBPrP1 and clinicopathological features of the pancreatic neoplasms were analyzed. T test and one-way analysis of variance were used for statistical analysis, and Spearman rank correlation test was used for correlation analysis. Results In benign group and malignant group, there were obvious cell atypia, and the cell atypia of malignant group was more significant than benign group. The contents of collagen fibers in benign group and malignant group were significantly higher than that in paracancer control group. IGFBPrP1, TGFβ1, α-SMA and collagen typeⅠwere highly expressed in the endochylema of the tumor cells and (or) the myofibroblast. The expression level of IGFBPrP1 in highly differentiated ductal adenocarcinoma was significantly higher than that in moderately and poorly differentiated ductal adenocarcinoma ((9.46±2.10)×104 vs. (6.48±1.38)×104 and (6.07±1.29)×104); t=7.430 and 6.767, both P<0.05). The expression of IGFBPrP1 in human pancreatic neoplasms was positively correlated with TGFβ1, α-SMA and collagen typeⅠ(r=0.530, 0.619, 0.625; all P<0.05). Conclusions IGFBPrP1 is highly expressed in pancreatic tumor tissue and its expression level may correlate with the histological grade of pancreatic neoplasms. The expression of IGFBPrP1 in human pancreatic tumor tissues may be accompanied by the activation of pancreatic stellate cells and the generation of cancer-related fibroblasts, and IGFBPrP1 may involve in the formation of tumor by changing the tumor microenvironment. Key words: Insulin-like growth factor binding protein-related protein 1; Pancreatic neoplasms; Tumor microenvironment; Transforming growth factor beta1; α-smooth muscle actin; Collagen type Ⅰ
{"title":"Expression and significance of insulin-like growth factor binding protein-related protein 1 in pancreatic neoplasms and its relationship with tumor microenvironment","authors":"Yanqin Wang, Li-xia Liu","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.02.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.02.005","url":null,"abstract":"Objective \u0000To observe the expression of insulin-like growth factor binding protein-related protein 1(IGFBPrP1) in human pancreatic tumor tissues and investigate its significance and relationship with clinic pathological characteristics and tumor microenvironment of the pancreatic neoplasms. \u0000 \u0000 \u0000Methods \u0000A total of 236 patients with surgically resected pancreatic tissue from January 2007 to December 2017 were selected from the First Hospital of Shanxi Medical University. Totally 236 patients were divided into paracancer control group (normal pancreatic tissue adjacent to the tumor, n=111), benign group (benign or low-grade malignant tumor such as solid pseudopapillary tumor, n=37), and malignant group (malignant tumors such as pancreatic ductal adenocarcinoma, n=88). The histomorphology and collagen deposition were observed using hematoxylin-eosin (H-E) staining and Sirius red staining in the three groups. The expressions of IGFBPrP1, transforming growth factor β1 (TGFβ1), α-smooth muscle actin (α-SMA)and collagen type Ⅰ of pancreatic tissues in the three groups were detected by immunohistochemical staining. The relationship between IGFBPrP1 and TGFβ1, α-SMA or collagen type Ⅰ, and the relathionship between IGFBPrP1 and clinicopathological features of the pancreatic neoplasms were analyzed. T test and one-way analysis of variance were used for statistical analysis, and Spearman rank correlation test was used for correlation analysis. \u0000 \u0000 \u0000Results \u0000In benign group and malignant group, there were obvious cell atypia, and the cell atypia of malignant group was more significant than benign group. The contents of collagen fibers in benign group and malignant group were significantly higher than that in paracancer control group. IGFBPrP1, TGFβ1, α-SMA and collagen typeⅠwere highly expressed in the endochylema of the tumor cells and (or) the myofibroblast. The expression level of IGFBPrP1 in highly differentiated ductal adenocarcinoma was significantly higher than that in moderately and poorly differentiated ductal adenocarcinoma ((9.46±2.10)×104 vs. (6.48±1.38)×104 and (6.07±1.29)×104); t=7.430 and 6.767, both P<0.05). The expression of IGFBPrP1 in human pancreatic neoplasms was positively correlated with TGFβ1, α-SMA and collagen typeⅠ(r=0.530, 0.619, 0.625; all P<0.05). \u0000 \u0000 \u0000Conclusions \u0000IGFBPrP1 is highly expressed in pancreatic tumor tissue and its expression level may correlate with the histological grade of pancreatic neoplasms. The expression of IGFBPrP1 in human pancreatic tumor tissues may be accompanied by the activation of pancreatic stellate cells and the generation of cancer-related fibroblasts, and IGFBPrP1 may involve in the formation of tumor by changing the tumor microenvironment. \u0000 \u0000 \u0000Key words: \u0000Insulin-like growth factor binding protein-related protein 1; Pancreatic neoplasms; Tumor microenvironment; Transforming growth factor beta1; α-smooth muscle actin; Collagen type Ⅰ","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"36 1","pages":"100-105"},"PeriodicalIF":0.0,"publicationDate":"2019-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81441294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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