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Objective To explore the pathologic features and distribution characteristics of upper gastrointestinal submucosal tumors (SMT).Methods From January 2013 to December 2017,at Department of Gastroenterology of Taizhou Hospital Affiliated to Wenzhou Medical University,clinical data of 1 182 hospitalized patients with 1 237 upper gastrointestinal SMT who underwent endoscopic therapy and diagnosed by pathology and immunohistochemistry was retrospectively analyzed including the pathological types,tumor of locations,endoscopic findings,layer of origin and tumor size.Results There were 473 esophageal SMT,including 387(81.8％) leiomyomas,located in the mucosal muscularis or muscularis propria;and 59(12.5％)cysts located in the submucosa or mucosal muscularis.There were 138(29.2％) lesions,159(33.6％) lesions and 176(37.2％) lesions in the upper,middle and lower esophagus respectively,and the most common type was leiomyoma.A total of 723 tumors were gastric SMT,among them 284 (39.3％) lesions were gastrointestinal stromal tumors (GIST) and 273(37.8％) lesions were leiomyomas,and all located in the muscularis propria.A total of 69(9.5％) lesions located at cardia,the common types were leiomyoma (55 lesions,79.7％) and GIST (nine lesions,13.0％).A total of 239 (33.1％) lesions located at gastric fundus,the common types were GIST (152 lesions,63.6％) and leiomyoma (79 lesions,33.1％).A total of 280 (38.7％) lesions located at gastric body,the common types were leiomyoma (138 lesions,49.3％) and GIST (111 lesions,39.6％).A total of 127 (17.6％) lesions located at gastric antrum,the common types were heterotopic pancrease (71 lesions,55.9％) and lipoma (26 lesions,20.5％),and all were located in the submucosa,some involved the muscularis propria.There were six (0.8％) lesions at gastric angle,and two (0.3％) at gastrointestinal anastomosis.Forty-one lesions were duodenal SMT,among them 23(56.1％) located at duodenal bulb,the common types were cyst (10 lesions,43.5％),lipoma (five lesions,21.7％) and heterotopic pancrease (five lesions,21.7％).A total of 18(43.9％) lesions located at descending duodenum,the common types were lipoma (nine lesions,50.0％) and cyst (five lesions,27.8％),and all lesions located in the submucosa.Conclusions The most common type of SMT in the esophagus and cardia is leiomyoma,however the SMT in gastric fundus and body are mostly leiomyomas and GIST,while in gastric antrum,most SMT are heterotopic pancreases and lipomas.In duodenal bulb and descending duodenum,the common types of SMT are cyst and lipoma.
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Objective To evaluate the safety and effectiveness of three endoscopic methods for re-moval of common bile duct stones (CBDs)accompanied with periampullary diverticula(PAD).Methods A total of 154 patients hospitalized at Taizhou Hospital and Taizhou No.1 People′s Hospital of Zhejiang prov-ince from December 2012 to July 2013 were divided randomly into three groups,i.e.,EST,EPBD and ES-BD group,and received the treatment of EST,EPBD and limited EST plus EPBD (ESBD)to extract CBDs, respectively.After 12 months of follow-up,the rate of full stone clearance,stones clearance rate in one time,the rate of mechanical lithotripsy,the rate of urgent lithotripsy,the average procedures,the average removal time and the complication incidence among three groups were compared.Results The rates of stone clearance in one time in group ESBD was higher than those of group EST and group EPBD (94.12% VS 78.43%,73.08%;P <0.05)with significant difference.The average procedures in group ESBD was lower than that of group EPBD (1.08 VS 1.31,P <0.05),which also showed significant difference.The occur-rence rates of early complication in group ESBD was lower than that of group EPBD (15.69% VS 34.61%, P <0.05).The occurrence rates of post-ERCP hyperamylasemia in group ESBD was lower than that of group EPBD (5.88% VS 21.15%)with significant difference (P <0.05).The incidence of pneumobilia in group EST was higher than those of group EPBD (52.27% VS 26.19%,P =0.013)and group ESBD (52.27%VS 27.66%,P =0.016).Conclusion The stone extraction efficiency of ESBD is better than that of EST and EPBD.Compared with conventional EST,ESBD shows similar safety level,and is safer than EPBD.So ESBD is a safe and effective method to remove CBDs with PAD.
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This article expounds the indication,preoperative ischemic tolerance test,evaluation of collateral circulation,different surgical modes,complications and their prevention in the treatment of intracranial aneurysms during extracranial-intracranial(EC/IC)graft bypass.It is considered that EC/IC bypass graft is an effective therapeutic mode in preventing the occurrence of cerebral ischemia in the treatment of intracranial aneurysms.
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Objective To evaluate the efficacy and reliability of intraoperative microvascular Doppler uhrasonography (IMDU)in urgent clipping surgery of ruptured aneurysms,and assess the impact of this method on the surgical procedure itself.Methods For 62 patients who underwent urgent clipping surgery for the treatment of ruptured aneurysms,both blood flow velocities in the aneurismal sac and in the adjacent vessels and alterations of the Doppler spectrum were determined by IMDU before and after aneurysm clipping.The findings of IMDU were analysed and compared with those of visual inspection of the surgical site and postoperative angiography. Results A relevant stenosis of an adjacent vessel induced by efip position that had escaped detection by visual inspection was identified by IMDU in 12 out of 62 patients.In addition, IMDU demonstrated a primarily incomplete clipping aneurysm in 4 out of 62 patients.The clipping aneurysm was repositioned on the basis of the IMDU findings in 16 out of 62 patients.The findings from IMDU equated with those from angiography in 38 eases.Conclusion IMDU is a safe,instantaneous,effective and reliable technique for the urgent dipping surgery of raptured aneurysms.
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Objective To discuss the implication of ectopic opening of the pancreaticobiliary duct in the performance of cholangiopancreatography (ERCP) and the diagnosis and treatment of cholangio-pancreatic disease. Methods We summarize the data of 1000 cases of ERCP in the past four years. Five patients were found with ectopic opening of the pancreaticobiliary duct. The positions, characteristics of ectopic opening and the characteristics of the mucosa disease around the ectopic papilla and cholangio-pancreatic disease were analyzed. Results In the 5 patients with ectopic opening of the papilla, one had the opening in the pyloric channal, two in the duodenal bulb, the other two in the distance of the descending part of duodenum. Mucosa erosion was found in the patients with ectopic opening in the pyloric channal and in the duodenal bulb. Conclusion The ectopic opening of the pancreaticobiliary duct may affect the finding of the papilla, but may not affect the performance of ERCP. The incidence of the cholangiopancreatic disease and the mucosa disease around the ectopic papilla will increase in the patients with ectopic opening.
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Along with the further development of biological science and technology,the taxonomy of organisms as well as classification of parasites have been modified and improved.However the taxonomic system of parasites used in China nowadays was established 25 years ago.This paper outlined the advances of biological taxonomy and introduces the Cox's new classification of parasites so as to promote parasitological research.
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Mice were divided into 3 groups:heavy infection group with 80 mice each was fed with 400 muscle larvae of Trichinella spiralis,light infection group with 60 mice each was fed by 200 larvae,and uninfected control (60 mice). The content of Cu,Zn and Fe in the dorsal hair samples was measured in the week of 1,3,5,7,9,11,13 and 15 after infection. Results indicated that the content of Zn,Cu and Fe in the two experimental groups reduced considerably in comparison to the control(P
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Objectives To examine sICAM-1 in Pneumocystis carinii pneumonia(PCP) and the effect of TMP-SMZ therapy on its level and on pathological and immunological changes in rats.Methods 50 female Wistar rats were randomly divided into normal group(N group),PCP model group(PCP group) and TMP-SMZ therapy group(SMZ group).1 mg of dexamethasone was injected intramuscularly twice a week for rats in PCP and SMZ groups to induce PCP.Normal saline was injected for N group in the same way.When the infection was confirmed,TMP-SMZ was given to rats in SMZ group by 25 mg/(kg.d) for 5 days for 3 courses with an interval of 2 weeks.sICAM-1 in serum was detected by ELISA,and the pathological changes in lungs and liver and the Pc in alveoli of lungs were observed.Results The level of sICAM-1 in PCP and SMZ groups at the 3rd week [(1.847?0.50) ng/ml,(1.787?0.59) ng/ml] was lower notably than that at 0 week[(2.407?0.81) ng/ml,[(2.478?0.59) ng/ml respectively](P0.05).Conclusion The sICAM-1 level in rats was low but significantly increases after the induction of PCP.
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In the presence of antischistosomular serum(Ab), the adherence of macrophages(M?). eosinophils(Eos) and neutrophils(Neu) to and the killing effect on schistosomula of Schistosoma japonicum were studied with a mouse model. In vitro experiment showed that all the three kinds of effectcr cells could adhere to the surface of the schistosomula when opsonized with specific Ab resulting in the significant increase in the percentage of dead schistosomula. When SPA was added to the system, the percentage of schistosomula with adherent cells decreased markedly. It was revealed that the adherence of cells was at least partially through the binding of Fc fragment of IgG to Fc receptor on the cell surfaces. After having been incubated with Ab and/or cells for 18 h in vitro, the schistosomula were inoculated into the peritoneal cavity of mice. The adult recovery rate 6 weeks after inoculation in groups Eos+Ab and M? + Ab were significantly lower than that of the control group (P
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Humans are negatively affected by parasitic infection.However, recent researches revealed that to some extent, parasitic infections are advantageous to humans.Parasitic infections are found to benefit patients of inflammatory bowel disease, diabetes mellitus, autoimmune disease and allergic disorder.Furthermore, they promoted studies on pathogenesis of these diseases, and therefore on safe and effective therapeutic strategy.In addition, by taking the Caenorhabditis elegans as model organism, researchers have made a breakthrough in the area of life science, including signal transduction, functional genomics and drug screening.