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Objective:To evaluate the influence on the results and safety of double-balloon enteroscopy (DBE) at different combination time.Methods:Patients who received combined DBE procedures in Nanjing Drum Tower Hospital from April 2019 to August 2020 were divided into the one-day combination group and the non-one-day combination group. The complete enteroscopy rate, time of anterograde approach, time of retrograde approach, total time of combined approach, adverse events, hospital stay and cost were compared.Results:Among 119 patients who received DBE, 23 patients were excluded due to small intestinal stenosis. The complete enteroscopy rate was 92.9% (39/42) in the one-day group and 74.1% (40/54) in the non-one-day group, showing significant difference ( χ2=4.390, P=0.036). There were significant differences in the time of retrograde approach (35.59±23.29 min VS 55.10±19.04 min, t=-4.080, P<0.001), total time of combined approach (89.10±27.82 min VS 114.20±24.55 min, t=-4.254, P<0.001), hospital stay (9.24±3.76 d VS 11.76±4.41 d, t=-2.599, P=0.011) between the two groups. There were no significant differences in the time of anterograde approach, hospital cost or adverse events between the two groups. Conclusion:Combined DBE on one day yields a higher complete enteroscopy rate, less examination time and less hospital stay, which is worth of clinical application.
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Objective To evaluate the effect of cyclophosphamide (CTX) on the prognosis of different types of systemic lupus erythematosus (SLE).Methods A retrospective cohort study,in which 1 372 lupus patients were included,was conduted in 26 hospitals in Jiangsu province from 1999 to 2009.The data was analyzed by the chi-square test,Mann-Whitney U test,Kaplan-Meier survival analysis and Cox regression analysis.Results 1 372 SLE patients were followed up,in which 582 patients (42.4％) were treated with cycloph-osphamide and 790 patients (57.6％) were not.There were statistically significant differences in SLE disease activity index (SLEDAI) at admission and discharge between the two groups (t=3.398,P=0.001;t=5.044,P＜0.01).The survival rate was significantly higher in CTX treatment group compared to those without CTX administration (x2=4.667,P=0.031).Female (P=0.018,HR=0.68),disease duration ≤7 years (P=0.033,R=0.697),decreased levels of complement C3 (P=0.047,HR=0.7),and patients treated with cyclophosphamide and glucocorti-costeroid (P=0.047,HR=0.734) were predictors for good prognosis for CTX treatment.In patients with central nervous system (x2=6.611,P=0.010),heart and lung (x2=7.223,P=0.007) and renal system involvement (x2=5.217,P=0.022),there were statistically significant differences in survival rate and survival time between the CTX treated group and untreated group.Conclusion Cyclophosphamide treatment was beneficial for female SLE patients with low complement,short disease duration and important organ involvement such as heart,lung,kidney and central nervous system.
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Cervical necrotizing fasciitis (CNF) is an aggressive infection associated with high mortality. Various complications have been described in previous literature. However, internal jugular vein thrombosis is rare in such lesions. We presented a case of internal jugular vein thrombosis caused by CNF and analyzed related literature.
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Humans , Fasciitis, Necrotizing , Jugular Veins , Neck , Venous ThrombosisABSTRACT
Objective To detect the expression of beta 2 adrenergic receptor in the infantile hemangiomas (IH) tissue and to explore its role in the pathological evolution of infantile hemangiomas as well.Methods 48 cases of infantile hemangioma were divided into two groups.29 cases were in the proliferating period,while the other 19 cases were in non-proliferating period.By using immunofluorescence technology,the endothelial nuclei and beta 2 adrenergic receptor of the IH tissue were marked by fluorescent tags,respectively,in two groups.The location of fluorescent labeling was shown in photos.By using the Image-Pro Plus 6.0 software,we analyzed and compared the average fluorescence intensity of endothelial cell nucleus and beta 2 adrenergic receptors in these two groups.Results Beta 2 adrenergic receptors were widely expressed in IH tissue,especially in endothelial cell nucleus shown in fluorescent images.The average fluorescence intensity of endothelial cell core in proliferating IH group was 0.031 ±0.002,which was much higher than that of fading period IH group (0.022±0.002).There was significant statistical different (P＜0.05).The average fluorescence intensity of beta 2 adrenergic receptor in proliferating IH group was 0.035± 0.003,which was much higher than that of fading period IH group (0.028± 0.002).There was significantly statistical different between the two groups (P＜0.05).Conclusions Beta 2 receptors are widely expressed in the endothelial cells of infantile hemangioma.
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Objective:To evaluate the effect of internal distraction osteogenesis in the treatment of complicated teeth-maxillofacial deformity.Methods:Clinical data of 1 0 cases with complicated teeth-maxillofacial deformity were analyzed retrospectively.In the first stage,the patients were operated by internal distraction osteogenesis.In the second stage,the distractor was removed after 3 to 6 months of consolidation period,followed by other operation for further occlusal reconstruction.Results:All the operations were per-formed as planned.The distraction distance was 7 -70 mm.The distraction process was smooth in all the cases.Occlusion was recon-structed and the deformity was corrected by following operation satisfactorily.Conclusion:Internal distraction osteogenesis is effective in the treatment of complicated teeth-maxillofacial deformity for further occlusal reconstruction and functional repair.
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Objective:To analyse the causes of early implantation failure and the therapeutic measures with re-implantation after the failures.Methods:6 cases of implantation failure including early infections,loosening and non-osteointegration were reviewed and trea-ted by re-implantation therapy,and the causes of failure were discussed and the effects of re-treatment were evaluated.Results:2 cases were found to be with infection of adjacent teeth after implantation and were treated by removal of the implant,socket curettage,root ca-nal therapy(RCT)and antibiotics followed by reimplantation.Implant loosening and non-osteointegration were observed in 4 cases, which were treated by the similar methods for the implant socket.Reimplantation was successful in all 6 cases followed-up for 1 -3 years.Conclusion:Preventive measure for implantation failure should include indication selection,control of infections in adjacent teeth and periodontosis,use of GBR technic and so on.Re-implantation following proper treatment of adjacent teeth and the socket of implant is effective for the treatment of implantation failure.
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ObjectiveTo analyze the risk factors for false negative diagnosis of obscure gastrointestinal bleeding (OGIB) by capsule endoscopy.MethodsA total of 133 OGIB inpatients,104 in true positive group and 29 in false negativc group,were reviewed.The features of demography,diseases and capsule endoscopy were collected and then analyzed,which included 10 variables like age,sex,time of bleeding,diseases accompanied,type and location of the disease,hemoglobin concentration,transit time of CE,quality of CE pictures and type of purgative agents.All data were analyzed with t test,and all the enumeration data were analyzed with chi square test.Logistic regression was used to analyze the correlation between the factors and results of diagnosis.ResultsAge ( t =2.095,P =0.038 ),concentration of hemoglobin ( t =2.143,P=0.034),type (X2 =20.222,P ＜0.001) and location (X2 =33.732,P ＜0.001) of the diseases,image quality of the CE (X2 =9.219,P =0.002 ) and the type of purgative agents (X2 =6.999,P =0.024) were found to have statistical differences between the two groups.Chi-square and partition Chi-square test revealed the occurrence of civerticulosis and lesion location,i.e.lower ileum and ileumcecum,were of statistical difference between the two groups (X2 =22.233,P ＜ 0.001 and x2 =24.412,P ＜ 0.001 ).Univariate logistic regression showed diverticulosis ( OR =0.102,P ＜0.001 ),lower bowel diseases ( OR =0.110,P ＜0.001 ),poor quality of CE pictures ( OR =0.258,P =0.004 ) and the use of sodium phosphate agent ( OR =0.367,P =0.027) were risk factors for false negative diagnosis,while older age facilitated diagnosis ( OR =1.024,P =0.041 ).However,multivariate logistic regression showed no statistic significance in type of purgative agent ( P =0.05 ) or the concentration of hemoglobin ( P =0.394).Furthermore,elder age facilitated positive diagnosis ( OR =1.031,P =0.032),while diverticulosis ( OR =0.118,P =0.001 ),lower bowel diseases ( OR =0.145,P =0.001 ) and poor quality of CE pictures ( OR =0.245,P =0.016) were correlated with higher probability of false negative diagnosis.ConclusionAge,disease type,disease location and image quality exert great influence on CE diagnosis.Diverticulosis,lower location of the diseases and poor CE image quality are risk factors for false negative diagnosis.
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ObjectiveTo evaluate the clinical value of capsule endoscopy (CE) image screening system developed by our group.MethodsBetween March 2011 and June 2011,50 patients (29 males and 21 females with a mean age of 45.7(45.7 ± 4.1 ) ) underwent CE in our department.CE images were reviewed,and processed by the screening system at the rate of 50％,60％,70％,80％ and 90％,respectively.After reviewing the remaining and the deleted frames,the endoscopists calculated the remaining rate of the lesions by recording the number of lesions of all patients and the number of remaining lesions.The procedure time and the total number of the frames of each case were also recorded.ResultsA total of 39 patients of 50 had lesions and the detection rate was 78％.91 lesions were detected in the 39 patients,most of whom had more than 2 lesions.When the prescribed deletion rate was less than or equal to 60％,the lesion remaining rate reached 100％,with a mean frames of the cases of 46 242,and the mean processing time of 15.62 min.ConclusionWith all the lesions remained,the system can delete 60％ similar frames in a very short time,which greatly reduces the diagnosis time and workload for endoscopist,and improves the efficiency of capsule endoscopy.