Cat scratch coIon( CSC ) is a new term for an endoscopicaIIy characteristic Iesion identified under coIonoscopy,which appears as bright red Iinear mucosaI tear commonIy seen in cecum and ascending coIon. The pathogenesis is considered to be the barotrauma of coIonic mucosa secondary to coIonoscopic insuffIation, and other mechanisms may aIso be impIicated in this process. CSC can be found in coIIagenous coIitis,diversion coIitis or in combination with other non-intestinaI diseases or conditions. With the recognition of CSC by cIinicians,reIated reports have increased. In this articIe,reIated Iiteratures were reviewed for a better understanding of this Iesion.

Objective To investigate the effect of long-term proton pump inhibitor on osteoporosis in elderly patients.Methods A total of 150 patients with peptic ulcer treated in our hospital from January 2011 to January 2015 were selected as the observation group.150 healthy subjects were selected as the control group.The age,height,body weight and PPI time of the two groups were recorded.The changes of bone mineral density before and after treatment were measured by bone mineral density analyzer,ineluding lumbar L1-4,radial density and ulna density.The changes of bone mineral density were observed and recorded in the observation group before treatment,six months,1 year and 2 years after treatment.Results After treatment,the levels of gastrin were significantly increased in the observation group,and the serum calcium concentration and bone mineral density were significantly decreased (P＜0.05).The density of lumbar vertebrae,radius and ulna was significantly lower in observation group than those of control group (P＜0.05).With the prolongation of PPIs,lumbar vertebrae,radius and ulna density in observation group showed a decreasing trend.Conclusion Long-term application of proton pump inhibitors in elderly patients can cause bone loss.

Objective To summarize the clinical characteristics and management of eosinophilic esophagitis (EoE) in China and improve the recognition of clinical doctor for this disease.Methods Electronic database was searched from 1993 to 2012 for case reports of EoE in Chinese patients.Data were enrolled according to the admission criterion,which included relatively complete medical records and cases confirmed by endoscopic biopsy and/or operation pathology.Results Data of 38 patients with EoE from 6 studies were included and analyzed.There were 24 males and 14 females.The age of onset was (47.2 ± 10.9)years.The process of the disease was (1.5 ± 1.8) years.The main symptoms included dysphagia (24/38,63％) and retrostemal pain (22/38,58％).Total 19 patients (83％,19/23) had allergy history and 20 patients (80％,20/25) had elevated blood eosinophil count.Lesions located at the mid-inferior esophagus mainly.Endoscopic manifestation included hyperaemia,erosion and fragile mucosa,and others such as mucosal nodular,ulcer,plaque and white exudates (18/38,47％).Eosinophil count in esophageal mucosa was (45.8 ± 34.1) numbers/HPF.Main treatment included corticosteroid and acid inhibitory medicine.Conclusions EoE is rare in Chinese people.EoE is more common in middle-aged males with chronic onset.Dysphagia and retrosternal pain is the common symptoms.Endoscopy and biopsy pathology are the methods for definition diagnosis.Corticosteroid and acid inhibitory medicine are the main treatment.

Objective To evaluate the efficacy and safety of different bismuth-based quadruple therapies for Helicobacter pylori (H.pylori) eradication.Methods From December 2012 to October 2013,240 patients with H.pylori infection were collected and evenly divided into clarithromycin group,levofloxacin group,furanzolidone group and metronidazole group.Each group received bismuth potassium citrate 220 mg,esomeprazole 20 mg and amoxicillin 1 000 mg twice daily.In addition,each group received clarithromycin 500 mg,levofloxacin 200 mg,furanzolidone 100 mg,and metronidazole 400 mg,respectively.The course of treatment was 10 days.At least four weeks after the end of therapy and withdrawal the medicine,patients underwent fasting 13C-urea breath test or 14C-urea breath test.The negative result indicated as successful H.pylori eradication.The adverse effects were observed and recorded during treatment.The rate of H.pylori eradication was analyzed by the intention to treat (ITT) analysis and per protocol (PP) analysis.Chi-square test was performed for eradication rate comparison among groups.Results According to ITT analysis,the eradication rate of clarithromycin group,levofloxacin group,furanzolidone group and metronidazole group was 81.67％ (49/60),88.33％ (53/60),93.33％ (56/60) and 73.33％ (44/60),respectively,and according to PP analysis which was 85.96％ (49/57),89.83％ (53/59),94.92％ (56/59) and 75.86％ (44/58),respectively.The differences among four groups were statistically significant (x2 ＝10.13 and 9.89,both P＜0.05).The differences between furanzolidone group and metronidazole group were statistically significant (x2 =8.64 and 8.55,both P＜0.01).There were no statisticaly significant differences in adverse effects among the four groups (x2 =0.47,P＞0.05).Conclusion The H.pylori eradication rate is high in furanzolidone contained bismuth based quadruple therapy and with good safety,which could be the first line treatment for H.pylori eradication.

Objective To investigate the dynamic abnormality of anorectum in elderly patients with chronic constipation.Methods Anorectal perfusion manometry was performed to detect the change of anal canal pressure and the rectal sensation capacity in 58 elderly patients and 36 non-elderly adults with chronic constipation.The results were compared retrospectively.Results Anal resting pressure in a chronic constipation was significantly lower in elderly patients than in non-elderly adults,with statistically significant difference [(59.74 ± 2.31) mmHg vs.(68.22 ± 2.37) mmHg,t =2.430,P =0.017].The incidence of paradoxical motility of anal sphincter was significantly higher in elderly patients with three abnormalities(incomplete defecation,Bristol stool scale type 3-5 and straining at defecation) than in elderly patients without above three abnormalities (x2 =8.880、11.540、6.070,P =0.003、0.001、0.014).Maximal tolerable volume was significant lower in elderly patients with straining at defecation and abdominal pain than in control group (t =2.140,2.260,both P ＜ 0.05).No correlation was observed between sex and anorectal motility in elderly patients with chronic constipation.Conclusions Anorectal motility in elderly patients with chronic constipation is different from that in non-elderly patients with chronic constipation.The dynamic abnormalities of anorectum in chronic constipation are different in elderly patients with different symptoms.

Objective To investigate the correlation between the drug resistance of Helicobacter pylori (H .pylori )and clinical eradication efficacy of bismuth-based quadruple therapies,and to guide clinical rational drug use in the region.Methods A total of 260 patients with H .pylori infections were collected.H .pylori from biopsied gastric mucosa tissues were isolated and cultured.Drug resistant rates of isolated H .pylori to metronidazole,clarithromycin,amoxicillin,levofloxacin and furanzolidone were tested.Patients were randomly divided into clarithromycin,levofloxacin,furanzolidone and metronidazole groups by completely randomized design.All patients received bismuth potassium 220 mg,esomeprazole 20 mg and amoxicillin 1 000 mg twice daily,and according to group received clarithromycin 500 mg, levofloxacin 200 mg,furanzolidone 100 mg and metronidazole 400 mg,twice daily,espectively.The treatment course was 10 days.At least four weeks after treatment,13 Curea breath test or 14 Curea breath test was taken.According to the intention to treat (ITT)and per-protocal (PP),the eradication rate of each group was caculated.Chi square test was performed to compare the differences between groups. Results The drug resistant rate of H .pylori to metronidazole,clarithromycin,amoxicillin,levofloxacin and furanzolidone was 94.2% (146/155 ), 21 .3% (33/155 ), 2.6% (4/155 ), 5 .8% (9/155 ) and 1 .9%(3/155),respectively.According to ITT analysis,the eradication rate of clarithromycin group, levofloxacin group,furanzolidone group and metronidazole group was 81 .5 %(53/65 ),90.8%(59/65 ), 93.8% (61/65 )and 75 .4%(49/65),respectively.And according to PP analysis which was 84.1 %(53/63),92.2%(59/64),95 .3%(61/64)and 79.0%(49/62 ),respectively.The differences between furanzolidone group and metronidazole group,clarithromycin group were staistcally significant (χ2ITT =8.509 and 4.561 ;χ2PP = 7.592 and 4.323,all P < 0.05 ).There was no statistical significance in the H .pylori eradication rate between resistant strains and sensitive strains of each group.Conclusion Bismuth-based quadruple therapy can overcome antibiotic resistance,the eradication rate of protocal with furanzolidone is higher and with good safety,which can be the first-line treatment for H .pylori eradication.

Chronic gastritis has varied clinical symptoms and prolonged course,and seriously affects the life quality of patients.Studies have shown that mood disorders might affect the pathogenesis of chronic gastritis.Aims:To investigate the incidence of anxiety and depression and its relationship with digestive symptoms,Helicobacter pylori (Hp) infection,degree and activity of inflammation in patients with chronic gastritis.Methods:A total of 235 patients with chronic non-atrophic gastritis were enrolled.Anxiety,depression,gastrointestinal symptoms,gastric mucosal inflammation and activity were evaluated,and infection of Hp was detected.Results:In the 235 patients,144 (61.3%)were accompanied by anxiety and/or depression:108 patients (46.0%)were accompanied by anxiety,129 patients (54.9%) were accompanied by depression,93 patients (39.6%)were accompanied by anxiety and depression.Incidence of abdominal pain,abdominal distention and early satiety,scores of digestive symptoms,positive rate of Hp infection and incidence of severe inflammation in patients accompanied by anxiety and/or depression were significantly higher than those in patients without anxiety and depression (P<0.05 ),but no significant difference in inflammation activity was seen between the two groups (P>0.05).Conclusions:Incidence of anxiety and depression in patients with chronic gastritis is high.Anxiety and depression are associated with abdominal pain,abdominal distention and early satiety,and can affect the inflammatory degree of gastric mucosa.Patients with anxiety and depression are susceptible to Hp infection.

OBJECTIVETo set up the technical system of multiplex fluorescence in situ hybridization M-FISH and to explore its application in detection of the complex chromosome abnormalities in leukemia.

METHODSThe complex chromosome abnormalities of two leukemia patients were analyzed by the combination use of classical cytogenetics, chromosome painting (CP), FISH and M-FISH.

RESULTSIn a case of acute lymphoblastic leukemia-L2, the complex karyotype: 46,XY,der(2)t(2;9),der(9)t(9;12;22) was identified by M-FISH, which was detected as 46,XY,der(9)t(9;12) by classical cytogenetics; In a case of acute monocytic leukemia-M5, the complex chromosome abnormalities: 46,XY,der(2)t(2;17), der(10)t(10;11;17), der(11)t(11;?) was revealed by M-FISH, which was confirmed by CP and FISH, and mixed lineage leukemia (MLL) gene was also found involved in this complex chromosome translocation.

CONCLUSIONM-FISH was proved to be a powerful tool to examine the complicated karyotypes and hopefully to elucidate nearly all chromosomal aberrations in leukemia and other cancers.

Objective:To investigate the influencing factors of endotracheal intubation and mechanical ventilation (ETI-MV) in patients with acute respiratory distress syndrome (ARDS) caused by viral pneumonia, and to provide evidence for individualized use of ETI-MV.Methods:Patients with ARDS due to viral pneumonia admitted to the respiratory intensive care unit (RICU) of the First Affiliated Hospital of Xinjiang Medical University were retrospectively analyzed from November 2017 to March 2022. The gender, age, concomitant diseases, clinical symptoms and signs, complications, lab results, ARDS severity, infectious virus type, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), respiratory support methods and prognosis-related variables were collected. Univariate analysis was performed on each factor, and the variables with statistical significance in the univariate analysis were subjected multivariate logistic regression analysis. The receiver operating characteristic curve (ROC curve) was drawn to evaluate the predictive value of each index for the implementation of ETI-MV.Results:A total of 117 patients were enrolled in the study, including 61 patients in the ETI-MV group, and 3 patients (4.9%), 39 patients (63.9%) and 19 patients (31.1%) with mild, moderate and severe ARDS, respectively. There were 56 patients in non-ETI-MV group, and the mild, moderate and severe ARDS cases were 16 cases (28.6%), 38 cases (67.8%) and 2 cases (3.6%), respectively. There was significant difference between the two groups ( P < 0.05). Univariate analysis showed that during 24 hours admitted to RICU, the levels of interleukin-6 [IL-6 (ng/L): 104.0±90.0 vs. 62.4±76.0], oxygenation index [PaO 2/FiO 2 (mmHg, 1 mmHg≈0.133 kPa): 123.9±30.9 vs. 173.6±28.5], the proportion of cases with pulmonary infiltrating opacity distribution range ≥ 3/4 lung fields [85.3% (52/61) vs. 21.5% (12/56)], APACHE Ⅱ score ≥ 16.5 [67.2% (41/61) vs. 42.9% (24/56)], the rate of nosocomial invasive aspergillus infection [14.8% (9/61) vs. 3.6% (2/56)], the percentage of nosocomial bacterial infection [16.4% (10/61) vs. 3.6% (2/56)], and the lowest CD4 + T lymphocyte count in the course of the disease [cells/mm 3: 192.2±35.8 vs. 215.0±58.3] had significant differences between ETI-MV and non-ETI-MV group (all P < 0.05). Multivariate Logistic regression analysis showed that during 24 hours admitted to RICU the distribution range of pulmonary infiltrating opacity ≥ 3/4 the lung fields [odds ratio ( OR) = 12.527, 95% confidence interval (95% CI) = 3.279-47.859, P < 0.001], APACHE Ⅱ score ≥ 16.5 ( OR = 30.604, 95% CI = 4.318-216.932, P = 0.001), PaO 2/FiO 2 ( OR = 0.948, 95% CI = 0.925-0.972, P < 0.001), CD4 + T lymphocytes cell count ( OR = 0.975, 95% CI = 0.955-0.995, P = 0.015), and nosocomial bacterial infection ( OR = 38.338, 95% CI = 1.638-897.158, P = 0.023) were independent risk factors for ETI-MV. The area under the ROC curve (AUC) of ROC showed that PaO 2/FiO 2 had the greatest predictive value for ETI-MV, with AUC of 0.903, sensitivity of 91.1% and specificity of 95.1% in case of cutoff value of 151 mmHg. The AUC of pulmonary infiltrating opacity distribution range was 0.809, the sensitivity of 85.2%, specificity of 78.6% when the cutoff value was ≥ 3/4 lung field. APACHE Ⅱ scores had the lowest predictive value for selecting ETI-MV, with AUC of 0.704, sensitivity of 83.6% and specificity of 57.1% under the cutoff value was 16.5. Conclusions:For patients with ARDS caused by viral pneumonia, PaO 2/FiO 2 is still the classic reference for selecting ETI-MV, however, the distribution range of pulmonary infiltrating opacity and the systemic severity of the disease during 24 hours admitted to the RICU may provide supplemental helpful information to determine whether the patients choose ETI-MV, especially for moderate ARDS.

Background: Computer-aided diagnosis based on deep learning technology is a research hotspot in the field of gastroenterology, and computer-aided diagnosis of colorectal polyps has received more and more attention. Aims: To validate a model based on deep learning for the automatic identification of colorectal polyps, and to analyze its auxiliary learning function for helping novice endoscopists. Methods: A total of 1 200 colonoscopy images (600 colorectal polyp images and 600 normal images) in the endoscopy center database of Qingdao Municipal Hospital (East) from January 2019 to January 2020 were retrospectively collected. Deep learning model was used to identify the 1 200 images. The sensitivity, specificity, accuracy and diagnosis time of deep learning model and 5 novice endoscopists for diagnosis of colorectal polyps were compared. Results: The deep learning model showed a sensitivity of 93.2%, specificity of 98.7%, accuracy of 95.9% for detecting colorectal polyps, and the diagnosis time of each image was (0.20±0.03) second. The sensitivity, accuracy, and diagnosis time of the model were superior to 5 novice endoscopists, and the specificity was superior to some novice endoscopists. The accuracies of model for polyps with size ≤5 mm and 6~9 mm were 88.1% and 96.8%, respectively, and were superior to 5 novice endoscopists; the accuracy of model for polyps with size ≥10 mm was 100%, and was similar to 5 novice endoscopists. The accuracy of model for polyps with protrude type was 94.8%, and was superior to some novice endoscopists; the accuracy of model for polyps with flat type was 91.7%, and was superior to 5 novice endoscopists. Missing the polyps with flat type (38.8%), polyps at mucosal folds (32.7%), and mistaking the mucosal folds as polyps (12.2%) were the main causes of false negative or false positive results of the model. Conclusions: The deep learning model has a high accuracy, sensitivity, specificity and shorter diagnosis time for diagnosis of colorectal polyps, and can be used to assist novice endoscopists in diagnosing small polyps and flat polyps.