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In recent years,with the change of lifestyle and environment,the incidence of colorectal cancer is increasing.Colorectal polyp is an important precancerous lesion of colorectal cancer;endoscopic early detection,early diagnosis are important for the prevention and treatment of colorectal cancer.Aims:To investigate the endoscopic findings, pathology and clinical features of colorectal polyps.Methods:Patients with colorectal polyps from January 2014 to June 2016 at the Third People's Hospital of Shenzhen were enrolled,and the general information data,endoscopic findings, pathology and canceration rate were retrospectively analyzed.Results:A total of 740 patients had colorectal polyps detected,the ratio of male to female was 1.75:1,559 (75.5%)patients were aged >40 years,70.4% of polyps were located in left hemicolon,the main pathological type of polyps were inflammatory polyps (29.0%),hyperplastic polyps (29.6%),tubular adenoma (30.3%).Cancer was found in 38 patients,canceration rate was 5.1%;the main pathological types of cancerated adenoma were tubular adenoma,tubular villous adenoma and villous adenoma,and 87.2%had a diameter greater than 1.5 cm,and were mainly located in left hemicolon (76.9%).Conclusions:Gender,age,pathological type, diameter of colorectal polyps are important factors of canceration.Male colorectal polyps patients with age >40 years, diameter greater than 1 .5 cm,tubular villous adenoma and villous adenoma should be paid attention and followed up.
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Objective To investigate the clinical effect of endoscopic esophageal variceal ligation (EVL)in the treatment of esophageal variceal bleeding (EVB)in patients with liver cirrhosis.Methods A total of 84 liver cirrhosis patients with EVB who were admitted to The Third People′s Hospital of Shenzhen,Guangdong Medical University,from December 2010 to July 2013 were divided into ligation group (group A,treated with EVL combined with somatostatin and esomeprazole)and control group (group B,treated with somatostatin and es-omeprazole),with 42 patients in each group.The hemostasis rate,rebleeding rate,incidence rate of complications,and mortality rate were observed in both groups,as well as the variceal eradication rate after EVL and risk factors for early rebleeding.The t -test was used for com-parison of normally distributed continuous data between two groups,and an analysis of variance was used for comparison between multiple groups;the Mann -Whitney U test was used for comparison of non -normally distributed continuous data between two groups,the Wilcoxon signed -rank sum test was used for comparison within each group,and the Kruskal -Wallis H test was used for comparison between multiple groups.The chi -square test or Fisher′s exact test was used for comparison of categorical data between groups.The Kaplan -Meier method was used to calculate survival rates,and the log -rank test was used to compare survival rates between groups.The logistic regression meth-od was used to investigate the influencing factors for dichotomous data.Results There was a significant difference in the hemostasis rate be-tween groups A and B (97.62% vs 80.95%,P =0.029).Compared with group B,group A had significantly lower rebleeding rates in 1 -2 years (15.38% vs 38.89%,χ2 =5.323,P =0.021)and 2 -3 years (15.38% vs 48.48%,χ2 =10.448,P =0.001).A total of 14 patients (33.33%)in group A and 7 patients (16.67%)in group B experienced adverse events,and 4 patients in group A and 9 patients in group B died within 3 years.Group A had significant improvements in the levels of alanine aminotransferase (ALT)and aspartate amin-otransferase at 1 week after treatment (Z =-2.177 and -2.044,P =0.029 and 0.041).Both groups had significant improvements in pro-thrombin time activity (PTA),prothrombin time (PT),international normalized ratio (INR),and albumin at 1 week after treatment (group A:Z =-4.007,t =3.866,Z =-4.152,t =-4.623,all P <0.001;group B:t =-5.069,Z =-3.870,Z =-3.909,Z =-5.245,all P <0.001).There was a significant difference in PTA at 1 week after treatment between the two groups (Z =-3.902,P <0.001).In group A,the overall disappearance rate of varices was 85.71% and the recurrence rate was 14.29%,and there was a signifi-cant correlation between the Child -Pugh score and diameter of the portal vein (F =3.319,P =0.047).Symptoms on admission,length of hospital stay,Child -Pugh score,spontaneous bacterial peritonitis,diameter of the portal vein,PT,INR,and ALT were risk factors for ear-ly rebleeding after ligation (all P <0.05).Conclusion EVL is a safe and effective method for the treatment of EVB in patients with liver cirrhosis and causes few complications.
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ObjectiveTo explore and analyze the distribution of NAT2 gene in Han population in Shenzhen andprovidethebasisfortreatmentof NAT2-relatedmetabolicdiseasesandcancer research. MethodThe study diluted the DNA sample(d0 ng/μl) as follows: 1 × 100, 1 × 101, 1 × 102, 1 ×103 , 1 × 104, to verify the sensitivity of detection of NAT2 gene polymorphism by real-time PCR. Mutation locus of 282,341,481, 590 and 857 of NAT2 in 554 normal samples were detected and genotyped by realtime PCR with Taqman probes. Forty-seven cases among 554 healthy controls were detected by DNA sequencing to verify the sensitivity, specificity and accuracy of this assay. ResultsThe lowest detection limit was 10-4 ng/μl. The frequencies of each allele of NAT2 were: *4 allele 64. 6％ (358/554), *5 allele 6. 3％ (35/554), *6 allele 25. 3％ ( 140/554), *7 allele 30. 0％ ( 166/554), * 11 allele 0. 6％ (3/554) The frequencies of main genotypes of NAT2 were as the follows : NAT2 *4/* 6 12.3％ ( 68/554 ), *6/* 78. 3％ (46/554), * 13/* 13 or * 12/* 12 or *4/* 4 7.6％ (42/554), *4/* 7 8. 1％ (45/554), * 7/* 1 312. 3％ (68/554), * 12 7.2％ (40/554), *6/* 13( * 12)5.6％ (31/554). The samples with 7 genotypes account for 89. 6％ (496/554) of the total cases.Rapid acetylation and Intermediate type accounting for 40. 5％ (224/554) and 46. 7％ (259/554) respectively were the main phenotypes of NAT2 in Han people in Shenzhen. In addition, the accuracy, specificity and sensitivity of the PCR were compared to direct DNA sequencing. The accuracy of 282, 341,481, 590 and 857 were 88.2％ (30/34), 87.5％ (7/8), 80. 0％(4/5), 100. 0％ ( 22/22 ) and 93.8％ ( 15/16 ) respectively. The specificities were 100. 0％ ( 13/13 ),94. 9％ ( 37/39), 100. 0％ ( 42/42 ) , 96.0％ ( 24/25 ) and 96. 8％ ( 30/31 ) respectively. The sensitivities were 91.5％ ( 43/47 ), 93.6％ ( 44/47 ), 97.6％ ( 46/47 ) 97.9％ ( 46/47 ) and 95.7％ ( 45/47 ),respectively. ConclusionsThe sensitivity, specificity and accuracy of real-time PCR established in this study is good. It can be widely used for clinical and scientific research. The major alleles of NAT2 of Han population in Shenzhen are * 4, *6, * 7. The most common slow acetylation genotype is *6/* 7. This study can provide a basis for NAT2-related metabolic diseases and cancer research.
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Objectives To study the relationship between serum HBV DNA and HBsAg, HBcAg expression in the hepatocytes in chronic hepatitis B(CHB) patients. Methods Quantitative polymerase chain reaction was used to assay the content of serum HBV DNA in 170 CHB patients. The expression of HBsAg and HBcAg in hepatocyctes was detected by immunohistochemical staining using liver biopsy. Results Although serum HBV DNA was negative, the expression of HBsAg in hepatocyctes was still observed in the CHB patients. In the CHB patients with lower level of serum HBV DNA, the positive rate of HBsAg expression in hepatocyctes was also lower (P