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Background: The prevalence of inflammatory bowel disease (IBD) is increasing worldwide, and anemia, one of the most prevalent extraintestinal manifestations of IBD, is still often underdiagnosed and undertreated. Aims: To analyze the correlations of clinical factors with anemia in patients with ulcerative colitis (UC). Methods: A retrospective analysis was conducted in 60 cases of UC admitted from September 2019 to May 2020 at the Second Affiliated Hospital of Zhengzhou University. Sixty healthy subjects were served as controls. Data of fasting venous blood sample analysis on admission were collected, and the correlations of indicators for anemia with the clinical factors were analyzed. Results: The indicators for anemia, including red blood cell (RBC) count, hemoglobin (Hb), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) etc. were significantly decreased in UC patients than in healthy controls (all P<0.05). RBC was lower in females than in males (P<0.05); RBC and HCT were lower in patients with pancolitis than in those with proctitis or left hemi-colon colitis (all P<0.05); RBC, Hb and HCT were lower in severe active UC than in mild active UC (all P<0.05). RBC, Hb, HCT and MCH were negatively correlated with two disease activity indicators for IBD, C-reactive protein (CRP) and/or erythrocyte sedimentation rate (ESR) (all P<0.05). Conclusions: Gender, as well as the disease extent, activity and severity are important clinical factors for anemia in patients with UC.
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Inflammatory bowel disease (IBD) is a chronic and recurrent inflammatory disease of gastrointestinal tract, including Crohn's disease and ulcerative colitis. The exact etiology and pathogenesis of IBD are still not clear. Neutrophil gelatinase-associated lipocalin (NGAL) plays an important role in regulating intestinal immunity, maintaining intestinal epithelial cell barrier, and coordinating the composition of intestinal flora. In addition, NGAL is useful for helping the clinical testing of IBD. This article reviewed the research progress of NGAL in IBD.
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MicroRNAs (miRNAs) are a group of short non-coding RNAs consisting of about 22 nucleotides that downregulate gene expression at posttranscriptional level through binding to the 3'-untranslated region (3'-UTR) of target mRNAs. With the increase in research about miRNAs, it is found that miRNAs could modulate the differentiation and secretion of immunocytes as well as the function of intestinal mucosal barrier. Besides, miRNAs could regulate the composition of intestinal microbiome, and could be used as crucial biomarkers for the diagnosis of inflammatory bowel disease (IBD). In this paper, the roles of miRNAs in the pathogenesis of IBD were reviewed through intestinal immunity and barrier function.
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Exosomes are extracellular vesicles with a diameter of 30-150 nm, which exist in multi-vesicular bodies in the form of intraluminal vesicles. Exosomes can be secreted by a variety of immune cells. Studies have shown that exosomes might play an important role in IBD through their components, such as annexin-A1 (ANXA1), the miRNAs and lipids. As a carrier of antigen presentation, it can affect the signaling pathways related to IBD, regulate the immune response and intestinal homeostasis. This article reviewed the relationship between exosomes and IBD.
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Objective To discuss the diagnosis and treatment of Cushing's disease without remission after transsphenoidal surgery.Methods 12 patients of Cushing's disease without remission after transsphenoidal surgery were investigated in this retrospective study.There were 2 males and 10 females with an average age of 36 (21-46) years old.Cushing's disease was diagnosed with the typical symptoms and signs of Cushing's syndrome,endocrinological examination and CT or MRI.Transsphenoidal surgery was performed in all patients.None of the patients achieved remission after operation.Serum and urinary free cortisol (UFC)were still elevated 3 months after operation.Subtotal adrenalectomy combined with pituitary radiotherapy were performed in 5 patients,single subtotal adrenalectomy in 4,pituitary radiotherapy in 2 and bilateral adrenalectomy with adrenal autotransplantation in 1 patient.Results Those receiving subtotal adrenalectomy combined with pituitary radiotherapy had no recurrence or Nelson's syndrome during 20 years of follow-up,but 4 patients receiving single subtotal adrenalectomy recurred after 2 to 9 years after operation.2 patients achieved remission with pituitary radiotherapy 1 to 2 years later without recurrence during 5 years of follow-up.One patient who underwent bilateral adrenalectomy with adrenal autotransplantation needed steroid replacement and Nelson's syndrome occurred during 2 years of follow-up because transplanted adrenal gland had no function.Conclusion The diagnosis of Cushing's disease should be reconfirmed for patients without remission after transsphenoidal surgery and the treatment should be individualized based on the results of operation,pathology and imaging.
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Objective To discuss the clinical feasibility and significance of retroperitoneal laparoscopic adrenalectomy for bilateral macronodular adrenal hyperplasia.Methods 9 patients with bilateral macronodular adrenal hyperplasia received retroperitoneal laparoscopic operations.5 cases had the typical clinical manif(e)stetions of Cushing's syndrome and 4 patients presented hypertension or diabetes mellitus without any sign of Cushing's syndrome.Body mass index was 18.8-31.2,with 25.0 as the average.Serum cortisol was 544-1746 nmol/L,with 984 nmol/L as the average.Urinary free cortisol (UFC) was 347-1989 nmol/24h with 1129 nmol/24h as the average.CT scan showed bilateral enlargement of the adrenal glands with multiple macronodules.The size of the adrenal gland was 6 cm × 5 cm × 4 cm to 10 cm × 6 cm× 3 cm,with 8 cm× 5 cm × 4 cm as the average.Results One patient underwent retroperitoneal laparoscopic bilateral adrenalectomy with replantation of adrenal gland tissue in scrotum,1patient underwent right lateral adrenalectomy combined with left subtotal adrenalectomy,4 patients underwent right lateral adrenalectomy ( 1case was converted to open surgery due to hemorrhage),and 3 patients underwent left lateral adrenalectomy.The average operation duration was 116 min,ranging from 60 to 165 min.The estimated average intraoperative blood loss was 110 ml,ranging from 20 to 600 ml.No severe complications like injury in great vessels or organs happened during the operation.Pathological diagnosis showed nodular or adenomatoid hyperplasia of adrenal cortex.The average postoperative follow-up was 58 months,ranging from 12 to 84 months.Clinical symptoms of Cushing's syndrome disappeared after surgery in the 5 cases with typical clinical features of Cushing's syndrome.Body weight and blood glucose recovered to normal level for those 4 cases presenting body weight increasement,hypertension or diabetes mellitus.2 cases with right lateral adrenalectomy received left adrenalectomy 33 and 41months after the first operation due to recurrence of Cushing's syndrome.Conclusions Retroperitoneal laparoscopic adrenalectomy for bilateral macronodular adrenal hyperplasia is technically feasible in experienced hands. Unilateral adrenalectomy can relieve most of the Cushing's symptoms.Bilateral adrenalectomy or unilateral adrenalectomy combined with contralateral subtotal adrenalectomy can be performed if the symptoms are not improved or recurred after unilateral adrenalectomy.
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Objective To evaluate the value of using fluorescence in situ hybridization (FISH)technique for the detection of chromosome aberration of urine exfoliated cells for the diagnosis of bladder tumor.MethodsFISH technique were used to detect the abnormalities of chromosome 3,7,17 and 9p16 site from 20 normal people, and to establish the threshold.The morning's first urinations were available from 75 patients with bladder cancer and 25 patients without urothelial tumor, then were detected using FISH technique and urine cytology respectively.The sample was considered positive if two or more probes results higher than the criteria,or one probe has two or more abnormal results.Results The sensitivity of single using were 73.3％ (55/75),76.0％ (57/75),62.7％ (47/75) and 62.7％ (47/75) for the 4 probes (3,7, 17 and 9p16)respectively.The sensitivity of combined detection was 85.3％ (64/75) and specificity was 96.0％ (24/25) The sensitivity and specificity of urine cytology examination was 9.3％ (7/75) and 100％ (25/25) .The sensitivity of FISH examination was significantly higher than that of urine cytology examination (85.3％ vs 9.3％ ,x2 = 57.00, P ＜ 0.001) .Sensitivity of FISH examination was not correlated with cancer pathologic grading(low vs high : 84.2％ vs 86.5％, x2 = 0.08, P ＞ 0.05)and clinical stage (ta-tl : 82.9％, t2-t4 :87.5％, x2 = 0.32 ,P ＞ 0.05) .ConclusionFISH technique is a non-invasive and effective method for the early diagnosis of bladder tumor and is more sensitive than urine cytology.Furthermore, FISH technique can be used to predict the tumor's biological behavivor and prognosis.
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Objective To explore the diagnosis and treatment of adrenocorticotropin-independent macronodular adrenal hyperplasia (AIMAH). Methods The clinical symptoms, endocrinological and radiological characteristics, treatment modalities, and postoperative clinical course of 12 AIMAH patients were retrospectively reviewed. There were 5 men and 7 women with an average age of 48 years old. Results All cases had some clinical features and biochemical evidence of Cushing's syndrome. The circadian rhythm of serum cortisol was abnormal. Low- and high-dose dexamethasone suppression tests failed to suppress cortisol secretion. CT or MRI scan showed bilateral enlargement of the adrenal glands with multiple macronodules. Bilateral adrenalectomy was performed in three patients and unilateral adrenalectomy combined with contralateral subtotal adrenalectomy was performed in one patient. Seven patients underwent unilateral adrenalectomy of the larger gland. The removed adrenal glands weighted within 8-96 g range and pathologic diagnoses were nodular or adenomatoid hyperplasia of adrenal cortex. The duration of postoperative follow-up was 14 to 124 months. Clinical symptoms of Cushing's syndrome disappeared after surgery in all cases and there was no Nelson's syndrome after bilateral adrenalectomy. Urinary free cortisol and serum cortisol were within normal ranges. No further enlargement of the contralateral gland has been noticed in patients who received unilateral adrenalectomy during the follow-up.Conclusions AIMAH had unique endocrinological and pathological features. Unilateral adrenalectomy appears to be an effective and safe alternative treatment for AIMAH. Bilateral adrenalectomy or unilateral adrenalectomy combined with contralateral subtotal adrenalectomy may be performed if the symptoms had not been improved or recurred after unilateral adrenalectomy.
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Objective To investigate the feasibihty and effectiveness of the fluorescence in situ hybridization(FISH)technique in the diagnosis of renal pelvic tumor.Methods FISH technique were used to detect the abnormalities of chromosome 3,7,17 and 9 p16 from 20 people without malignancy.The morning's first urine were availahled from 15 patients with hematuria and suspected of renal mass by imaging,then were studied by FISH technique and urine cytology respectively.The sample was considered positive if two or more probes results were higher than the criteria,or one probe had two or more abnormal results.Results Eight of 15 patients with hematuria were renal pelvic urothehal carcinoma,5 were renal clear cell carcinoma,1 was renal chromophobe cell carcinoma,1 was xanthogranulomatous pyelonephritis,confirmed by pathology.All of the 8 renal pelvic carcinoma were considered positive by FISH technique,while only 1 was considered positive by urine cytology.The variation rate of chromosome 3,7,17 were 100%(8/8)and chromosome 9 p16 was 75%(6/8).Six of 7 non-renal pelvic carcinoma were negative by FISH technique,but all Were negative by urine cytology.Conclusion FISH technique is a non-invasive and effective method for the diagnosis of renal pelvic tumor,and it's more sensitive than urine cytology.
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Objective To discuss the diagnosis and treatment of primary adrenal lymphoma(PAL).Methods Two cases of PAL were retrospectively analyzed and the literature was reviewed.Results One patient received laparoscopic right adrenalectomy and was diagnosed as B cell Non Hodgkin's lymphoma by pathology.Immunohistochemical stains showed positive for CD20 (B cell originmarker) but negative for CD3.0ne cycle CHOP ( eyclophosphamide,doxorubicin,vincristine,andprednisone) chemotherapy was given post operation but the patient died three months after operationbecause of dyscrasia.Another patient received 2-stage bilateral laparoscopic adrenalectomy.Immuno histoehemical staining demonstrated positive CD3 (T cell origin marker) activity,but negative CD20 ac tivity and T cell Non l lodgkin's lymphoma was confirmed.Then the patient received four cyclesCHOP chemotherapy and was in good condition during S months follow up.Conclusions PAL is arare disease and has a poor prognosis.Most reported PAL patients who received only one therapeuticmodality have unsatisfactory survival rates.A combination of therapeutic modalities such as surgeryfollowed by chemotherapy and/or radiotherapy may improve prognosis for patients with PAL than sin gle modality therapy.
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Laryngeal conservation surgery trys for more laryngeal function reservation in precondition of radical cure,and presently has been the main method of treating larygeal carcinoma.The article discusses the moral principle that should be followed in the course of developing conservation laryngeal surgery on the point of view of medical ethics.To get curative effect,the surgeons should possess high responsibility and masterly skill,and highly regard multi-discipline cooperation and multimodality therapies.
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This paper analyzes the influence of modern enterprise system on managerial mechanism and industrial management of pharmaceutical enterprise, and the countermeasure that should be adopted by enterprise are discussed as well.
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The present paper analyzes the situation of Chinese pharmaceutical industry which has been faced with carrying out market oriented economy and resuming General Agreement on Tariffs and Trade. The price will be free, all of the enterprises will compete on the basis of equality, and the annex will be developed during competition. On the one hand, the scale of some enterprises will be enlarged, and on the other hand a number of enterprises cannot be maintained any longer. Furthermore, foreign medical commodity will enter into our market pounding at that of domestic industry. Under this circumstance every enterprise should pay more attention on the quality, variety and cost of its own products, make vigorous efforts to carry out GMP to meet the challenge.
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On the basis of data collected from an investigation on the variety structure of drug consumption in the cities and rural areas of China, we analyse the developing trend of the variety structure of drug consumption in China and elaborate the differences between urban and rural areas and between China and overseas.
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To study the changes in vestibular function in Parkinson's disease patients, and its significance, eletronystagmography (ENG) was used to examine 54 patients with Parkinson's disease, and also 20 hea thy elderly subjects. The results of vestibular function tests including sensory organization test, nystagmus test, cold caloric test and positional test of these two groups were recorded for statisticed analysis. It was found that the rate of vestibular dysfunction in Parkinson's disease patients were 81 4%, and that of the controls 30%. There was significant difference between the two groups ( P