Mesenteric arteriovenous dysplasia/vasculopathy (MAVD/V) is a rare vasculopathy involving both mesenteric arteries and veins with unique vascular lesions. The diagnosis requires comprehensive analysis with histological and clinically relevant examination data, as well as differentiation from Crohn′s disease and other chronic ischemic bowel diseases. This paper summarizes the clinicopathological features of two cases of MAVD/V and reviews the literature in order to improve the understanding of MAVD/V among clinicians and pathologists.

Mesenteric arteriovenous dysplasia/vasculopathy (MAVD/V) is a rare vasculopathy involving both mesenteric arteries and veins with unique vascular lesions. The diagnosis requires comprehensive analysis with histological and clinically relevant examination data, as well as differentiation from Crohn′s disease and other chronic ischemic bowel diseases. This paper summarizes the clinicopathological features of two cases of MAVD/V and reviews the literature in order to improve the understanding of MAVD/V among clinicians and pathologists.

This paper reports a case of adult-onset autoimmune enteropathy (AIE) diagnosed and treated at the Department of Gastroenterology in Zhongnan Hospital of Wuhan University. The patient had intermittent abdominal pain with diarrhea and weight loss as the main clinical manifestations. Laboratory examination results showed increased IgG and IgE, and positive antinuclear antibody (ANA) . Obvious villous atrophy of duodenum and ileum was observed under endoscopy. The intestinal biopsy showed villous atrophy of duodenum, reduction of goblet cells, lymphocyte infiltration of the lamina propria and flattening and blunting of villous of ileum mucosa. The patient was comprehensively diagnosed as AIE. Prednisone therapy is effective and the patients is being followed up closely. Adult-onset AIE is rare. Summarizing the diagnosis and treatment experience of this patient is helpful to improve clinicians′ understanding of diagnosis and differential diagnosis of AIE.

Crohn′s disease (CD) with vascular disease is difficult to distinguish from simple vascular disease and easy to misdiagnose clinically. A case of CD with vascular disease misdiagnosed as fibromuscular dysplasia is reported to improve clinicians′ understanding of the two diseases.

This paper reports a case of adult-onset autoimmune enteropathy (AIE) diagnosed and treated at the Department of Gastroenterology in Zhongnan Hospital of Wuhan University. The patient had intermittent abdominal pain with diarrhea and weight loss as the main clinical manifestations. Laboratory examination results showed increased IgG and IgE, and positive antinuclear antibody (ANA) . Obvious villous atrophy of duodenum and ileum was observed under endoscopy. The intestinal biopsy showed villous atrophy of duodenum, reduction of goblet cells, lymphocyte infiltration of the lamina propria and flattening and blunting of villous of ileum mucosa. The patient was comprehensively diagnosed as AIE. Prednisone therapy is effective and the patients is being followed up closely. Adult-onset AIE is rare. Summarizing the diagnosis and treatment experience of this patient is helpful to improve clinicians′ understanding of diagnosis and differential diagnosis of AIE.

Crohn′s disease (CD) with vascular disease is difficult to distinguish from simple vascular disease and easy to misdiagnose clinically. A case of CD with vascular disease misdiagnosed as fibromuscular dysplasia is reported to improve clinicians′ understanding of the two diseases.

The red doctor’s spirit is an important spiritual guidance for the cultivation of medical talents during the development of medical and health services in China. The teaching reform, which is oriented towards position competence, requires that students majoring in public health management should not only master solid medical knowledge and professional skills, but also possess an ability to handle medical public relations, such as shaping an excellent image of the organization, improving the medical interpersonal communication, and managing public relations crisis. Under the guidance of inheriting the red gene and innovating the medical education, the driving force of learning should be "serving the people to improve their health" led by "political firmness" , the learning goal "striving for perfection" inspired by "excellent technology" , and the working criterion "respecting patients, involving full participation and shouldering public responsibility" embodied in "making selfless dedication and helping the wounded and dying" . The article based on the characteristic culture of red medicine in the Air Force Medical University, applied the teaching method of role-playing case simulations to explore the teaching practice road of "theory-experience-practice-reflection" .

Objective:To compare the efficacy of fusion and non-fusion hybrid operation with Dynesys system with the traditional fusion operation with rigid instrumentation in the patients with multi-segment lumbar degenerative disease.Methods:A total of 30 patients with multi-segment lumbar degenerative disease who were subjected to operation from January 2017 to October 2019 in Shenzhen People's Hospital were included in the study. There were 13 males and 17 females, age: 60.8±13.2 years, range: 25 to 83 years. 28 patients with two segments, 1 with three segments, and 1 with four segments. The patients were divided into two groups, i.e the hybrid operation group (13 cases, 9 males and 4 females, average age: 56.6 years, range: 25 to 83 years) versus the traditional fusion group (17 cases, 4 males and 13 females, average age: 63.9 years, range: 46 to 80 years). The main outcome measures were visual analogue scale (VAS), Oswestry disability index (ODI), range of motion (ROM), adjacent segment degeneration (ASD) and complications.Results:There were no statistically significant differences in operation data, such as operation time, intraoperative blood loss, postoperative drainage volume and length of hospitalization, between the two groups. There were no significant differences for ROM in the surgical segments between the two groups before operation (hybrid group and traditional group were 9.6°±4.9° vs. 8.9°±6.1°, t=0.341, P=0.736, respectively). However, after 12 months follow-up, the ROM disappeared in the traditional group and was partially preserved in the hybrid group, with statistically significant differences (hybrid group and traditional group were 5.4°±2.7° vs. 0°, t=9.104, P=0.001, respectively). There was a statistical difference in intervertebral disc height between the two groups at 12 months post-operation, though no statistical difference was found before operation (8.8±1.9 mm vs. 10.5±1.7 mm, t=2.927, P=0.006). There was no statistically significant difference in the intervertebral disc height of the upper adjacent vertebrae between the two groups before and after operation. There were statistically significant differences in ODI scores before operation (63.4%±11.0% vs. 71.3%±9.2%, t=2.146, P=0.041), and 12 months post-operation (17.2%±2.1% vs. 15.5%±2.3%, t=2.091, P=0.046), while no statistical difference was found in VAS scores. Conclusion:The fusion and non-fusion hybrid operation with Dynesys system has comparable clinical efficacy with the traditional fusion operation with rigid instrumentation in the treatment of multisegment lumbar degenerative disease. Meanwhile, the hybrid surgery can preserve the motion of surgical segments and provide a dynamic stability of the vertebral body. The hybrid surgery can be used as a new surgical method for multi-segment lumbar degenerative disease.

Pathology plays an important role in diagnosis and differential diagnosis of inflammatory bowel disease (IBD) . However, histopathological features of IBD vary among different patients and at different stages in the same patient. There is a lack of definitive morphological diagnostic criteria for IBD. Meanwhile, diagnostic accuracy is affected by training level and diagnostic experience of pathologists. In order to improve the pathological diagnosis of IBD, and to provide advice on practical diagnostic issues of IBD in China, experts guideline of pathological assessment was discussed by an expert group of pathologists and gastroenterologists.

Pathology plays an important role in diagnosis and differential diagnosis of inflammatory bowel disease (IBD) . However, histopathological features of IBD vary among different patients and at different stages in the same patient. There is a lack of definitive morphological diagnostic criteria for IBD. Meanwhile, diagnostic accuracy is affected by training level and diagnostic experience of pathologists. In order to improve the pathological diagnosis of IBD, and to provide advice on practical diagnostic issues of IBD in China, experts guideline of pathological assessment was discussed by an expert group of pathologists and gastroenterologists.