ABSTRACT
Celiac disease (CD) is a type of intestinal malabsorption syndrome, in which the patients are intolerant to the gliadin in dietary gluten, resulting in chronic diarrhea and secondary malnutrition. The disease is common in Europe and the United States, but only sporadic reports are found in East Asia including China. Is CD really rare in China? We examined 62 patients by capsule endoscopy for chronic diarrhea from June 2003 to March 2008. Four patients with chronic diarrhea and weight loss were diagnosed to have CD. Under the capsule endoscopy, we observed that the villi of the proximal small bowel became short, and that the mucous membrane became atrophied in these four patients. Duodenal biopsies were performed during gastroscopy and the pathological changes of mucosa were confirmed to be Marsh 3 stage of CD. A gluten free diet significantly improved the conditions of the four patients. We suspect that in China, especially in the northern area where wheat is the main food, CD might not be uncommon, and its under-diagnosis could be caused by its clinical manifestations that could be easily covered by the symptoms from other clinical situations, particularly when it came to subclinical patients without obvious symptom or to patients with extraintestinal symptoms as the initial manifestations.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Asian People , Celiac Disease , Epidemiology , Pathology , China , Epidemiology , Endoscopy , GastroscopyABSTRACT
<p><b>OBJECTIVE</b>To investigate the efficacy and safety of gastrointestinal pacemaker in treatment of gastric dynamic disorders.</p><p><b>METHODS</b>Sixty patients with more than two symptoms as postprandial fullness, epigastric pain,epigastric fullness, belch, nausea, hypercoria,anorexia,vomiting and at least for twelve weeks were divided into three groups randomly. Thirty patients were treated with gastrointestinal pacemaker for ten days(pace maker group); fifteen patients were treated with gastrointestinal placebo machine for ten days (control group); fifteen patients received treatment with cisapride 5 mg three times daily, thirty minutes before meal (cisapride group) for ten days. Electrogastrogram(EGG) was performed on before and after treatments, the mean frequency and mean amplitude of EGG, the clinical symptoms and adverse reactions were observed.</p><p><b>RESULTS</b>Total efficacy of pace maker group, control group and cisapride group was 90.0%, 46.6% and 86.7%, respectively. The score of symptoms was significantly decreased after treatment with gastrointestinal pacemaker and cisapride (P<0.05). Before and after meal EGG exam showed that average frequency was reversed to normal level after treatment with gastrointestinal pacemaker.</p><p><b>CONCLUSION</b>Gastrointestinal pacemaking can relieve symptoms and improve the average frequency of EGG in patients with gastric dynamic disorders.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Electric Stimulation Therapy , Gastrointestinal Motility , Stomach Diseases , TherapeuticsABSTRACT
<p><b>OBJECTIVE</b>To describe the brief survey of alcohol intake and the incidence of alcohol liver disease in Zhejiang province.</p><p><b>METHODS</b>18,237 requested persons aged over 18 years were selected by multi-stage stratified cluster sampling in Zhejiang province. Questionnaire about alcohol consumption, hepatic ultrasonic scan and detection of hepatic enzymes and markers of HBV and HCV were carried out. Daily alcohol intake more than 40g (including equal to 40g/d) was essential for the diagnosis of alcoholic liver disease.</p><p><b>RESULTS</b>Among the 18,237 persons (male 12,042, female 6195), the average daily alcohol intake was (17.7 +/- 27.2) g. The incidence of alcoholic liver disease in Zhejiang province was 4.34% (male 6.36%, female 0.36%) in the whole population. Four subtypes were separated as alcoholic cirrhosis, alcoholic fat liver, alcoholic hepatitis and mild alcoholic injury in liver with the corresponding incidence of 0.68%, 0.94%, 1.51% and 1.21% separately.</p><p><b>CONCLUSION</b>Alcoholic liver disease is found to be a common disease in Zhejiang province, indicating an urgent need for the public education on alcohol abuse and the treatment on related health problems</p>