This article reports a case of enteropathy-associated T-cell lymphoma (EATL) who was repeatedly misdiagnosed as Crohn′s disease (CD) . The article focuses on the differential diagnosis between EATL and other intestinal diseases, aiming to improve the understanding of this disease and reduce misdiagnosis and mistreatment.

This article reports a case of enteropathy-associated T-cell lymphoma (EATL) who was repeatedly misdiagnosed as Crohn′s disease (CD) . The article focuses on the differential diagnosis between EATL and other intestinal diseases, aiming to improve the understanding of this disease and reduce misdiagnosis and mistreatment.

Background: Helicobacter pylori (Hp) infection is a major risk factor for development of gastric cancer. Some studies demonstrated a high fungal infection rate in gastric cancer tissues. There are many methods to diagnose Hp and fungal infections, and each has its advantages and disadvantages. Aims: To investigate the value of immunofluorescence staining for diagnosis of Hp and fungal infections in gastric mucosal biopsy specimens. Methods: A total of 450 gastric cancer patients undergoing gastroscopy from September 2019 to September 2020 at the General Hospital of Eastern Theater Command, PLA, were enrolled in this study. Gastric mucosal biopsy specimens were collected and stained with immuno-fluorescence, HE, and methylene blue, respectively, for detection of Hp infection, and stained with immunofluorescence and PAS, respectively, for detection of fungal infection. The microscopic findings and detection rate of various staining methods were analyzed and compared. Results: When stained with immunofluorescence, Hp was indicated by orange fluorescence on a dark black background, which was easily to be identified as compared with HE staining and methylene blue staining. The detection rate of immunofluorescence was superior to HE staining and equal to methylene blue staining (49.6% vs. 30.9%, P<0.05; 49.6% vs. 48.4%, P>0.05). Fungi stained by immunofluorescence showed brilliant blue fluorescence, while those stained with PAS showed blurred red and were difficult to be distinguished from the red background. The detection rate of immunofluorescence staining was superior to PAS staining (31.6% vs. 20.2%, P<0.05). Conclusions: Immunofluorescence staining is a convenient, fast and effective method for detecting Hp and fungal infections in gastric mucosal biopsy specimens, and is helpful for diagnosis of gastric diseases.

Objective: To investigate the effects of extreme high and low temperatures on admission risk of acute ischemic stroke (AIS) and its etiology subtypes. Methods: From January 1, 2016 to December 31, 2017, the data of inpatients with AIS from Zhongnan Hospital of Wuhan University and the meteorological data and air pollution data from China Meteorological Data Network in the same period were collected continuously. According to TOAST etiology criteria, the patients were divided into large artery atherosclerosis (LAA), small vessel occlusion (SVO), cardioembolism (CE), and stroke of other etiology (SOE). A time series analysis of the distributed lag model was used to investigate the effects of extreme high and low temperatures on the admission of patients with AIS and its etiology subtype, and air pollution, air pressure, humidity, and wind speed were used as confounding factors to exclude interference. Results: A total of 1 413 patients with AIS were enrolled, including 906 men (64.4%), age 67.7±12.8 years. The thresholds of extreme low temperature (1%, 5% and 10% of the average temperature) were 0.7 ℃, 3.3 ℃, and 4.9 ℃. The thresholds of extreme high temperature (90%, 95% and 99% of the average temperature) were 29.2 ℃, 31.6 ℃, and 32.9 ℃. Extreme high temperature increased the risk of hospitalization in patients with AIS (lag 0 day; relative risk [RR] 1.54, 95% confidence interval [CI] 1.01-2.34). It was mainly related to the increased risk of hospitalization in patients with CE subtype (lag 0 day; RR 7.64, 95% CI 1.19-49.09). There was no significant correlation between the extreme low temperature and the risk of hospitalization of AIS (lag 2 days; RR 0.99, 95% CI 0.71-1.37), but it significantly increased the risk of hospitalization in patients with LAA subtypes (lag 2 days; RR 3.04, 95% CI 1.33-6.95), and it was still statistically significant at lag 3 days (RR 2.87, 95% CI 1.57-5.25) and lag 4 days (RR 2.19, 95% CI 1.15-4.15). Conclusion Extreme high temperature may increase the risk of hospitalization in patients with AIS and CE subtypes, while extreme low temperature may increase the risk of hospitalization in patients with LAA subtypes.

Objective: To study the clinical significance of serum calcitonin in the diagnosis and treatment of medullary thyroid carcinoma and to analyze its cost-benefit. Methods: One hundred and forty one patients with medullary thyroid carcinoma who undertook calcitonin test and frozen pathological examination were enrolled in this study from Oct 2012 to Mar 2018. Using the method of χ² test, the positive rate of calcitonin test and frozen pathological examination in diagnosis of medullary thyroid carcinoma(MTC) were compared. Firstly, we compared the correct checkout cost of calcitonin test and that of frozen pathological examination (total number of patients×cost of examination/the correctly detected number of patients) . Secondly, we calculated whether calcitonin test help patients save money(average cost of treatment in hospital for MTC×number of patients who were evaluated to be candidate for surgery-cost of calcitonin test×total number of patients)/total number of patients. Results: 139 patients were positive in calcitonin test among 141 patients, and the positive rate was 98.58%. 91 patients were positive in frozen pathological examination, and the positive rate was 64.54% (χ²=97.821, P<0.000 1) . Cost-benefit analysis showed that the correct checkout cost of calcitonin test and frozen pathological examination were 71.01 yuan and 426.10 yuan, also,1 371 938.64 yuan could be saved totally and 9 730.06 yuan could be saved per patient because of calcitonin test. Conclusion Serum calcitonin test had a significant effect on the diagnosis and treatment of medullary thyroid carcinoma and was economical and practical.

Objective To investigate the effect of short-term environmental ozone (O3) exposure on hospitalization risk of acute ischemic stroke (AIS) and its subtypes.Methods From January 1,2016 to December 31,2017,the hospitalization data of patients with AIS from Zhongnan Hospital of Wuhan University,air pollutant data published by China Air Quality Online Monitoring and Analysis Plafform,and the meteorological data published by China Meteorological Data Network were collectcd.According to TOAST etiological classification criteria,the patients with AIS were divided into large-artery atherosclerosis (LAA),small-artery occlusion (SVO),cardioembolism (CE),and stroke of other etiology (SOE).The effect of short-term O3 exposure on the hospitalization risk of AIS and its subtypes was analyzed retrospectively using a distributed lag non-linear model of time series analysis.Results A total of 1 413 patients with AIS were enrolled,including 910 males (64.4％),aged 67.7± 12.8 years (range,18-99 years).Short-term O3 exposure increased the overall hospitalization risk of AIS [relative risk (RR) 1.06,95％ confidence interval (CI) 0.99-1.13],mainly caused by increased hospitalization risks of LAA (RR 1.17,95％ CI 1.02-1.34;lag 5 d) and SVO (RR 1.24,95％ CI 1.06-1.45;lag 3 d).After introducing double pollutant (O3 + other pollutants) model its RR did not have significant changes.A stratified analysis based on demographic characteristics and vascular risk factors showed that the different populations had different sensitivities to the acute hazard effects of O3.Conclusion Short-term exposure to O3 could significantly increase the hospitalization risks of LAA and SVO.

Objective To observe the clinical effect of endoscopic retrograde cholangiopancreatography (ERCP)biliary stent implantation and percutaneous transhepatic cholangiography(PTCD)in the treatment of malignant obstructive jaundice(MOJ).Methods Eighty-eight patients with MOJ treated in the Second Affiliated Hospital of Hainan Medical University from January 2013 to March 2016 were selected and then randomly divided into ERCP group and PTCD group,44 cases in each group.ERCP group received biliary tract stent implantation via ERCP pathway, and PTCD group underwent percutaneous transhepatic biliary puncture.The success rate,clinical efficacy,liver function and complication rate of the two groups were compared.Results The success rate of ERCP group was 93.18%(41/44),and the success rate of PTCD group was 90.91%(40/44).There was no significant difference between the two groups(P>0.05).In terms of the clinical curative effect,the total effective rate of ERCP group was 92.68%(38/41),the total effective rate of PTCD group was 90.00%(36/40),there was no significant difference between the two groups(P>0.05);the low obstruction efficiency in ERCP group was significantly higher than that of PTCD group(100.00%vs.75%),the high obstruction efficiency in ERCP group was significantly higher than that of PTCD group (96.43% vs.83.33%),the differences between the groups were statistically significant(χ2=3.503,2.771,P<0.05);in terms of the liver function recovery after treatment,the liver function index of patients with low obstruction in ERCP group were better than that in patients with high obstruction,while in PTCD group,patients with high obstructive had better liver function,compared to the low obstruction patients,the differences were statistically significant(P<0.05); the complication rate in ERCP group and PTCD group were11.36% and 15.91%,the difference was not statistically significant(P>0.05).Conclusion The ERCP pathway and PTCD pathway implantation of biliary metal stent have great clinical efficacy,while in comparison,ERCP pathway performs better in low obstruction and PTCD pathway was more suitable in high obstruction.In the course of clinical treatment,the selection of surgical approach should be based on the different obstruction sites of the patients,so as to obtain the best therapeutic effect.

Objective To investigate relativity between the epidemiology of HPV and cervical carcinoma in Dali region,Yunnan province,through detecting the 13 high-risk human papillomavirus infection and Thinprep cytologic test in 2153 cases.Methods Real-time PCR was used to detect the 13 high-risk HPV (16,18,31,33,35,39,45,51,52,56,58,59,68) in2153 cases and 1604 cases were checked with Thinprep cytologic test.Results In 2153 samples,260 cases were infected with HPV,with the positive rate of 12.08％.The highest positive rates were ＞60 years old (18.18％),then ＞20 and ≤30 years old (14.41％);there was no significant difference in the positive rate among the various age groups (P =0.384).There were 1465 negative for intraepithelial lesion ormalignancy (NILM) cases (91.33％),86 atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells cannot exclude HSIL (ASC-H) cases (5.36％),32 low-grade squamous intraepithelial lesion cases (LSIL) cases (2.00％),21 high-grade squamous intraepithelial lesion cases (1.31％) through Thinprep cytologic test.The correlation coefficient is 0.893.Conclusions The infection rate of HPV in Dali region,Yunnan Province,has no significant difference among the various age groups.Application of 13 high-risk HPV infection test combined with Thinprep cytologic test could be more effective in screening cervical carcinoma.

Primary salivary duct carcinoma(SDC) featured with giant cell tumor(GCT) is a extremely rare, relatively new understanding lesion and its histogenesis has not been fully defined. This paper reported a case of SDC associated with GCT, its clinical, histopathologic features and histological origin were discussed in combination with literature review.
Carcinoma, Ductal ; Carcinoma, Squamous Cell ; Giant Cell Tumors ; Head and Neck Neoplasms ; Humans ; Salivary Ducts ; Salivary Gland Neoplasms

To investigate the influence of bear bile on rat hepatocarcinoma induced by diethylnitrosamine (DEN), a total of 40 rats were randomly divided into 4 groups: normal control group, model group, and two bear bile treatment groups. The rat liver cancer model was induced by breeding with water containing 100 mg x L(-1) DEN for 14 weeks. The rats of the bear bile groups received bear bile powder (200 or 400 mg x kg(-1)) orally 5 times per week for 18 weeks. The general condition and the body weight of rats were examined every day. After 18 weeks the activities of serum alanine transaminase (ALT), aspartate transaminase (AST) and total bilirubin (TBIL) were detected. Meanwhile, the pathological changes of liver tissues were observed after H&E staining. The expression of proliferative cell nuclear antigen (PCNA) and a-smooth muscle actin (alpha-SMA) in liver tissue were detected by immunohistochemical method. After 4 weeks the body weights of rats in normal group were significantly more than that in other groups (P < 0.05); and that in the two bile groups was significantly more than that in the model group. Compared with normal group, the level of serum glutamic-pyruvic transaminase and total bilirubin increased significantly in other groups; compared with model group, these two indexes decreased significantly in two bile groups. Hepatocellular carcinoma occurred in all rats except for normal group; there were classic cirrhosis and cancer in model group while there were mild cirrhosis and high differentiation in two bile groups. There were almost no expressions of PCNA and alpha-SMA in normal group while there were high expressions in model group; the two bile groups had some expressions but were inferior to the model group, and alpha-SMA reduced markedly. It indicated that bear bile restrained the development of liver cancer during DEN inducing rat hepatocarcinoma, which may be related to its depressing hepatic stellate cell activation and relieving hepatic lesion and cirrhosis.