Objective To explore the diagnosis and treatment of tumor associated gastrocolic fistula (GCF).Methods The records of the 4 patients with GCF between August 2008 to February 2014 were retrospectively analyzed.Three female and one male patients,those whose average age were 61 years,have been pathologically diagnosed postoperatively as gastrocolic fistula caused by malignant diseases.The main clinical symptoms were diarrhea (3 cases),fecal vomitus (3 cases),weight loss (4 cases),and abdominal pain (4 cases).Positive diagnostic tests for GCF included gastroscope (3 cases),colonoscope (1 case),barium enema (1 case),upper gastrointestinal contrast (2 cases).Results En-bloc resection of the involved gastrocolic region have been performed for all,2 patients underwent radical gastrectomy and colon resection and 2 patients were taken on palliative procedure.Pathology indicated adenocarcinoma all,Immunohistochemical detection for CK20,CDX-2 were applied for identifying the originations of tumors.Delayed gastric emptying and DIC occurred in one patient who died in 3 months after the operation,anastomotic leakages were found in 2 cases.The survival patients were all discharged and taken capecitabine combined with Oxaliplatin for chemotherapy.Conclusions Endaoscopy and gastrointestinal imaging are main evidences for diagnosis of GCF.En-bloc resection of the involved gastrocolic region were recommended,enterostomy was safer than entero-anastomosis in one stage procedure.The originations of tumors may be identifying according to the pathological characteristic and CDX-2,CK20 staining.Adjuvant chemotherapy should be applied.

Child ; Child, Preschool ; Diagnostic Errors ; Female ; Humans ; Infant ; Infectious Mononucleosis ; diagnosis ; Male ; Suppuration ; diagnosis ; Tonsillitis ; diagnosis

Objective To assess the inlfuence of depth on liver stiffness measurement with real-time shear wave elastography (SWE) and determine the optimal depth for SWE in liver. Methods SWE of liver was performed on 89 healthy volunteers between May 2012 and November 2012. The depths of each liver were varied from 0 cm to 7 cm (from the liver capsule) in 1 cm increment and there were 8 depth groups in total. Then the elastic modulus of liver in each depth group were measured three times by SWE. The body mass index (BMI) and the distance from body surface to liver capsule were documented. The success rates and the mean elastic modulus of each group were calculated. Results The success rates of 0-7 cm were 0, 98.9%(88/89), 98.9%(88/89), 98.9%(88/89), 71.9%(64/89), 24.7%(22/89), 3.4%(3/89) and 0, respectively. The success rates were highest in 1 cm, 2 cm and 3 cm groups but signiifcant decreased with the increasement of depths in 4 cm, 5 cm and 6 cm groups ( 3 cm vs 4 cm, χ2=25.94, P<0.001; 4 cm vs 5 cm, χ2=39.68, P<0.001;5 cm vs 6 cm,χ2=16.79, P<0.001). The mean elastic modulus of 1 cm, 2 cm, 3 cm, 4 cm and 5 cm groups were (4.77±0.99), (4.68±0.99), (4.76±0.95), (5.19±1.10) and (5.41±0.95) kPa, respectively. The mean elastic modulus of 4 cm and 5 cm groups were signiifcant higher than those of 1 cm, 2 cm, 3 cm groups (4 cm vs 1 cm, t=-2.85, P=0.005;4 cm vs 2 cm, t=-3.49, P=0.001;4 cm vs 3 cm, t=-2.76, P=0.006;5 cm vs 1 cm, t=-3.13, P=0.002;5 cm vs 2 cm, t=-3.66, P=0.000;5 cm vs 3 cm, t=-3.05, P=0.003). In the group of 4 cm, the BMI and the distance from body surface to liver capsule of the volunteers performed successfully and unsuccessfully were (20.70±2.87), (22.07±2.42) kg/m2 and (1.45±0.25 ), (1.60±0.29) cm, respectively. In the group of 5 cm, the BMI and the distance from body surface to liver capsule of the volunteers performed successfully and unsuccessfully were (19.82±2.76), (21.49±2.72) kg/m2 and (1.35±0.21), (1.54±0.26) cm respectively. The BMI had no signiifcant difference between the successful and unsuccessful groups (t=-2.83, P=0.108 for 4 cm;t=0.77, P=0.709 for 5 cm), but the distance from body surface to liver capsule was signiifcantly different (t=26.51, P=0.012 for 4 cm;t=79.57, P=0.004 for 5 cm). Conclusions The success rates and elastic modulus were different at different depths. SWE should be performed at the depths of 1-3 cm from the liver capsule.

We evaluated the patient in the early,advanced or healing phase of the disease by MRI in the treatment of chronic brucellosis spondylitis and to guide the clinical treatment.MRI images of 40 patients with clinically diagnosed chronic brucellosis spondylitis were analyzed retrospectively.The imaging findings of early,advanced and healing patients were summarized.MRI showed abnormal signals in the vertebral body,intervertebral disc,paraspinaI and psoas muscle.It is early stage if the intervertebral space was normal,and advanced stage if combined with interverbral space stenosis.It demonstrated short T1 and short T2 signal or similar to the normal vertebral body,combined with intervertebral space stenosis,for the healing stage.According to the specific imaging manifestations of chronic brucellar spondylitis in the course of disease development,it is possible to evaluate the clinical stage of the disease and guide the rational selection of clinical treatment.

Objective To investigate the relationship between parvovirus B19 infection and systemic lupus erythematosus(SLE).Methods Sera from 51 patients with SLE and 20 normal controls were exam- ined for IgG and IgM antibodies against parvovirus BI9 by ELISA(produced by IBL Hamburg Company, Germany).Results Anti-Bl9 antibodies were found more frequently in sera from SLE patients than in normal controls,IgM and [gG antibodies were detected in 11(17.65%)and 9(21.57%)of 51 SLE pa- tients respectively.It was observed that the SLEDAI scores were higher in patients with B19 IgM positive group than those of the negative group(P＜0.05).The sera levels of ALT/AST were elevated more frequently in patients with BI9 IgM positive group than in negative group(P＜0.05).However,there was no association between the presence of anti-IgM and clinical manifestations in patients with SLE(P＞0.05).Five SLE pa- tients with positive B19 IgM were followed up for 2 years.SLEDA1 scores of these patients were markedly decreased(P＜0.05),but the levels of auto-antibodis(ANA,dsDNA)didn't change(P＞0.05).And the levels of ALT/AST decreased as usual.Conclusions It is suggested that parvovirus B19 infection may ex- acerbate the onset of SLE,but we eould not find a correlation between parvovirus B19 infection and prog- nosis of the disease.

Objective To analyze the cost of capsule endoscopy in diagnosing small bowel bleeding and to compare it with traditional diagnostic methods.Methods The patients suspected with small bowel bleeding were divided into group A(n=58,collected during 1998 to 2005)diagnosed with traditional processes and group B (n=93,collected during 2002 to January 2005)diagnosed with capsule endoscopy.The diagnostic yield,specific treatments,examination costs and other accumulated costs of two groups was compared.The examination cost ratio and the integration cost ratio were evaluated.The sensitivity analysis was performed.Results The diagnostic yield of small bowel bleeding in group A and group B were 22.4%(13/58) and 86%(80/93),respectively.The total of examination costs were 133 750 RMB and 790 500 RMB,respectively.The examination costs in group B(RMB 9881.3/each) was slightly lower than group A(RMB 10 288.5/each).Furthermore,as the diagnostic yield of group B was significantly higher than group A(P=0.001).The specific treatments based on the results of the diagnosis was 37.4% higher in group B(49.5%) than group A(12.1%).That means the cost of repeat- ed consultations,emergencies room visit,examinations,supporting treatments and hospitalizations in group B were significantly decreased.After the adjustment,the cost in group B(RMB 9881/patient) was lower than group A(16 361.5 RMB in one month—97 424.0 over 5 years/patient).The total cost of each patient in group A was 6480.2—87 542.7 RMB more than group B,which represented 1.7—9.9 folds increase.Conclusions The patients who suspected with small bowel bleeding and had a negative results of gastroscopy and colonoscopy were recommended to have capsule endoscopy which yields early diagnosis and less cost.

Objective To evaluate the effects of capsule endoscopy in the diagnosis and prognosis of small bowel tumors.Methods Three hundred and fifty-eight consecutive patients who underwent capsule endoscopy for suspected small bowel disease during May 2002 to Feb.2007 were examined.The final diagnosis was confirmed pathologically.Results Thirty-three(9.22%) out of 358 patients were identified as small bowel tumors[male 14/female 19,mean age(51?17)years].Of them,23(69.70%) patients had malignant tumors and ten(30.30%) had benign tumors.Obscure gastrointestinal bleeding were found in 26 cases,bleeding with abdominal pain in 2 cases,bleeding with diarrhea in 1 case,abdominal pain in 2 cases,abdominal pain with diarrhea in 1 case and vomiting in 1 case.All patients with benign tumors underwent surgery for their tumor.No further bleeding or abdominal pain after resection was found in all but one patient.Of the patients with malignant tumors,all expect two underwent surgery.Three patients accepted palliative surgery while eighteen patients received a curative resection.The locations of the tumor detected by capsule endoscopy were correlated well with the results of surgery.Conclusions Capsule endoscopy promises a higher diagnostic yield in small bowel tumors. h may improve the diagnosis of small bowel tumors and alter management thoroughly.

Six bacterial strains were isolated from lead-zinc mine tailings with the age of about 100 years, and their phylogenetic position was determined by the analysis of partial 16S rRNA gene sequence. Three strains belonged to genus Arthrobacter, and were close to A. nicotinovorans and A. histidinolovorans. Other three strains belonged to genus Agromyces, and were close to Ag. mediolanus. All of them were resistant to Pb(NO_(3))_(2), CdCl_(2), ZnSO_(4), CuSO_(4) and CoCl_2. Relatively, minimal inhibitory concentration(MIC)of Zn~(2+) and Co~(2+) of three Arthrobacter strains was significantly higher than that of three Agromyces strains. Additionally, these strains displayed strong adsorption of Pb(NO_(3))_(2), CdCl_(2), ZnSO_(4). Averagely three Arthrobacter strains could adsorb about 400mg of Pb~(2+), 177mg of Cd~(2+) or 80mg of Zn~(2+) per gram of dried cells. Therefore, these strains were important candidates for application in bioremediation of heavy metal-contaminated environment.

Objective To investigate the association of the polymorphism of rs3750344 and rs1435252 of G-protein family GABABR2 gene with hypertension in population of Xinjiang Uygur. Methods 785 Uygur subjects were surveyed with the cardiovascular phenotypes.Tagging single nucleotide polymorphisms (tSNPs) of rs3750344 and rs1435252 of GABABR2 gene were typed with Taqman. Linkage disequilibrium and haplotype were analysed with Haploview software. Results The frequency of rs1435252 was significantly different (P<0.05) between hypertension group (GG 43.0%, GA 43.6%, AA 13.5%) and normal control group (GG 44.8%, GA 47.6%, AA 7.6%). The subjects with GA/AA genotype significantly increased risk of hypertension (OR=1.38, 95%CI: 1.08~1.76). The associations remained significant after control for age and gender (P<0.05). The frequency of rs3750344 was not significantly different (P=0.204), as TT 71.4%, TC 25.2%, CC 3.5% in the hypertension group, and TT 68.5%, TC 29.6%, CC 1.9% in the normal control group. Conclusion The rs1435252 polymorphism A allele of GABABR2 gene is a risk factor for hypertension in the Uyghur population.

OBJECTIVETo investigate the placement of a long tube into the small intestine under fluoroscopic guidance and to evaluate its decompression effect on early postoperative small bowel obstruction (EPSBO).

METHODSFifty-four patients with EPSBO requiring decompression between April 2010 and July 2014 were enrolled in the study. Insertion of a long tube was guided by fluoroscopy. We first used the guide wire to pass the pylorus and then used the 10 Fr feeding tube as an exchangeable tube to put the superstiff wire into the duodenum. Finally the long tube could be passed over the guide wire through the pylorus into the intestine. The total procedure time, the radiation exposure time, and the incidence of complications were evaluated.

RESULTSThe long tubes passed into the jejunum on initial insertion for all patients, so the success rate of this technique was 100%. The long tube was inserted into ileum in 18 patients. The mean total procedure time was 34.4 ± 8.6 minutes, and the mean radiation exposure time 18.9 ± 6.8 minutes. A total of 47 patients (87%) experienced full recovery following long-tube decompression and without the need for surgical intervention.

CONCLUSIONSUsing the wire-exchange technique, it is easy to place a long tube into the small bowel under fluoroscopic guidance. This decompression method is safe and effective for management of EPSBO.

Adult ; Aged ; Decompression, Surgical ; methods ; Female ; Fluoroscopy ; Humans ; Intestinal Obstruction ; surgery ; Male ; Middle Aged ; Postoperative Complications ; surgery ; Retrospective Studies