In vitro effect of uremic serum on barrier function and inflammation in human colonocytes / Efeito in vitro do soro urêmico sobre a função de barreira e inflamação em colonócitos humanos

ABSTRACT Introduction: In chronic kidney disease (CKD), it has been suggested that alterations within the gut are associated with an inflammatory state and uremic toxicity. Studies suggest that uremia may impair the function of the intestinal barrier via the promotion of increased intestinal permeability. To understand the mechanisms that are involved in intestinal barrier damage in the setting of uremia, we evaluated the in vitro effect of uremic serum on transepithelial electrical resistance (TER), inflammation, and apoptosis in intestinal epithelial cells (T84). Methods: Pools of serum from healthy individuals, patients not on dialysis, and patients on hemodialysis (Pre-HD and Post-HD) were prepared. T84 cells were incubated for 24 h in medium, of which 10% consisted of the pooled serum from each group. After incubation, the TER was measured and the following parameters were determined by flow cytometry: expression of toll-like receptors (TLRs), production of reactive oxygen species (ROS), and apoptosis. The level of IL-6 in the culture supernatant was determined by ELISA. Results: No difference was observed among the groups with respect to TER, apoptosis, and ROS or the expression of TLR-2, TLR-4, and TLR-9. IL-6 secretion was higher (p < 0.001) in cells that were incubated with pre- and post-HD serum. Conclusion: The results that were obtained from this model suggest that uremic serum per se does not seem to impair the integrity of intestinal epithelial cells. The increased IL-6 secretion by cells that were incubated with HD serum suggests a potential effect of uremia in the intestinal inflammatory response.

RESUMO Introdução: Tem sido sugerido que na doença renal crônica (DRC) a uremia pode causar alterações intestinais, tais como modificações na microbiota e danos à barreira intestinal, e que estas possíveis alterações podem ter uma relação importante com o estado inflamatório e a toxicidade urêmica apresentadas por pacientes com DRC. Objetivos: Avaliar o efeito in vitro do soro urêmico sobre a permeabilidade da monocamada de células epiteliais do intestino, inflamação e apoptose. Métodos: Pools de soro foram preparados a partir de soros de indivíduos saudáveis, pacientes em tratamento conservador e em hemodiálise (Pré e Pós-HD). As células T84 foram incubadas por 24 horas com os diferentes pools. Em seguida a TER foi medida e as células foram submetidas às seguintes análises: apoptose, produção de espécies reativas de oxigênio (EROs) e expressão de receptores toll-like (TLR) por citometria de fluxo e detecção de IL-6 no sobrenadante da cultura por ELISA. Resultados: Não foram encontradas diferenças, entre os grupos, com relação a TER, apoptose, EROs e expressão de TLR-2, TLR-4 e TLR-9. Já a secreção de IL-6 foi maior (p < 0,001) pelas células incubadas com soro pré-HD e pós-HD. Conclusão: Os resultados obtidos a partir deste modelo sugerem que a uremia per se parece não comprometer a integridade das células epiteliais do intestino. O aumento da secreção de IL-6 pelas células incubadas com soro HD (pré e pós) sugere um potencial efeito da uremia sobre a resposta inflamatória intestinal.

Comparison of clinicopathological features between gastric polyps and colorectal polyps / 中华全科医师杂志

Objective To compare of clinical and pathological features between gastric polyps and colorectal polyps.Methods The clinical characteristics and pathological features of 2 125 patients with gastric polyps and 4 924 patients with colorectal polyps admitted in Wenzhou People's Hospital from 2004 to 2013 were compared.The detection rates,the indication of endoscopy,distribution,number,size and pathological type of gastric polyps and colorectal polyps were analyzed.Results The detection rate of gastric polyps was 3.1％ (2 125/69 575) and that of colorectal polyps was 24.5％ (4 924/20 124) (χ2 =9 886.401,P ＜0.01).The detection rates of gastric polyps in age groups ＜ 20,20-39,40-59 and ≥60 were 1.8％ (23/1 302),1.8％ (399/22 600),3.4％ (1 137/33 087) and 4.5％ (566/12 586),respectively (χ2 =238.867,P ＜ 0.01);and those for colorectal polyps were 6.6％ (14/211),11.6％ (623/5 385),26.0％ (2 622/10 070) and 37.3％ (1 665/4 458),respectively (χ2 =934.724,P ＜ 0.01).The detection rates of gastric polyps in age groups 20-39,40-59 and ≥60 were lower than those in colorectal polyps(all P ＜ 0.01).The detection rate of gastric polyps in males was lower than that in females(2.3％,848/36 447 vs.3.9％,1 277/33 128,χ2 =273.807,P ＜0.01),while the detection rate of colorectal polyps in males was higher than that in females (28.8％,3 239/11 230 vs.18.9％,1 685/8 894,χ2 =262.518,P ＜ 0.01).Diarrhea and gastrointestinal bleeding in patients with colorectal polyps was more common than those in patients with gastric polyps (23.5％,1 156/4 924 vs.2.5％,54/2 125,χ2 =558.080,P＜0.01;12.1％,597/4 924 vs.2.4％,51/2 125,χ2 =168.150,P ＜0.01).Single polyps were more common in gastric polyps than colorectal polyps(80.7％,1 714/2 125 vs.67.6％,3 331/ 4 924,χ2 =186.337,P ＜0.01).Polyps with size ≥ 1.0 cm were more common in colorectal polyps than those in gastric polyps (24.3％,1 197/4 924 vs.13.6％,289/2 125,χ2 =102.333,P ＜ 0.01).The proportion of inflammatory and hyperplastic types in gastric polyps was higher than that in colorectal polyps (67.1％,1 378/2 125 vs.27.5％,1 273/4 924,χ2 =934.394,P ＜0.01;26.9％,552/2 125 vs.9.9％,459/4 924,χ2 =319.588,P ＜0.01);while the proportion of adenoma and canceration in gastric polyps was lower than that in colorectal polyps (1.7％,34/2 125 vs.62.4％,2 893/4 924,χ2 =2 135.743,P ＜0.01;0.4％,9/2 125 vs.4.8％,221/4924,χ2 =80.362,P＜0.01).Conclusions In comparison with gastric polyps,the detection rate of colorectal polyps is higher.The detection rate of gastric polyps is higher in females,w hile that of colorectal polyps is higher in males.The detection rates of gastric polyps andcolorectal polyps increase with the age.The main pathological type of gastric polyps is inflammatory,while that of colorectal polyps is adenoma.The canceration of colorectal polyps is more common than that of gastric polyps.

Effect of Reducing Abdominal Compression during Prone CT Colonography on Ascending Colonic Rotation during Supine-to-Prone Positional Change

OBJECTIVE: To determine the effect of reduced abdominal compression in prone position on ascending colonic movement during supine-to-prone positional change during CT colonography (CTC). MATERIALS AND METHODS: Eighteen consecutive patients who had undergone prone CTC scanning with cushion blocks placed under the chest and hip/thigh to reduce abdominal compression and had confirmed sessile polyps > or = 6 mm in the well-distended, straight, mid-ascending colon, were included. Radial location along the ascending colonic luminal circumference (degrees) was measured for 24 polyps and 54 colonic teniae on supine and prone CTC images. The supine-to-prone change ranging between -180degrees and +180degrees (- and + for internal and external colonic rotations, respectively), was determined. In addition, possible causes of any ascending colonic rotations were explored. RESULTS: Abdominal compression during prone CTC scanning completely disappeared with the use of cushion blocks in 17 of 18 patients. However, some degrees of ascending colonic rotation were still observed, with the radial location changes of -22degrees to 61degrees (median, 13.9degrees) for the polyps and similar degrees for teniae. Fifty-four percent and 56% of polyps and teniae, respectively, showed changes > 10degrees. The radial location change of the polyps was significantly associated with the degree of anterior shift of the small bowel and mesentery (r = 0.722, p < 0.001) and the degree of posterior displacement of the ascending colon (r = 0.566, p = 0.004) during supine-to-prone positional change. CONCLUSION: Ascending colonic rotation upon supine-to-prone positional change during CTC, mostly in the form of external rotation, is not eliminated by removing abdominal compression in prone position.

The polypoid ganglioneuroma associated with hyperplastic polyposis

No abstract available.

Tuberculosis intestinal: un diagnóstico para no olvidar. Reporte de un caso / Intestinal tuberculosis: A diagnosis to remember. A case report / Tuberculose intestinal: um diagnóstico para não esquecer. Reporte de um caso

La tuberculosis continúa siendo una causa importante de morbimortalidad en Colombia y el mundo, con un aumento en las formas extra pulmonares, de las cuales el compromiso intestinal ocupa el sexto lugar. Sus manifestaciones clínicas son inespecíficas y pueden simular múltiples condiciones, lo que hace de su diagnóstico un reto clínico. Este artículo describe el caso de una paciente con tuberculosis intestinal, a quien no se documentó un hallazgo confirmatorio, pero por la sospecha clínica y hallazgos paraclínicos sugestivos, se decide iniciar tratamiento antituberculoso, con respuesta clínica favorable luego de dos semanas.

Tuberculosis remains a major cause of morbidity and mortality in Colombia and the world, with an increase in extra-pulmonary forms, amongst which intestinal involvement ranks sixth. Clinical manifestations are nonspecific and can mimic many conditions that make diagnosis a clinical challenge. This article describes the case of a patient with intestinal tuberculosis, for whom a confirmatory finding was not documented, but due to clinical suspicion and paraclinical suggestive findings, it was decided to initiate TB treatment. The patient presented a favorable clinical response after two weeks of onset.

A tuberculose continua sendo uma causa importante de morbimortalidade na Colômbia e no mundo, com um aumento nas formas extra pulmonares, das quais o compromisso intestinal ocupa o sexto lugar. Suas manifestações clínicas são inespecíficas e podem simular múltiplas condições, o que faz de seu diagnóstico um objetivo clínico. Este artigo descreve o caso de uma paciente com tuberculose intestinal, a quem não se documentou uma descoberta confirmatório, mas pela suspeita clínica e descobertas laboratoriais sugestivas, se decide iniciar tratamento antituberculoso, com resposta clínica favorável logo de duas semanas.

Tuberculosis gástrica que simula otra patología: caso clínico / Gastrointestinal tuberculosis that mimics other pathologies: A clinical case / Tuberculose gástrica que simula outra patologia: caso clínico

La tuberculosis gástrica es una entidad rara que simula otras patologías. Suele asociarse con diagnósticos tardíos debido a sus características clínicas y forma de presentación atípica en este tipo de órganos. Se extrajeron los datos de la historia de una paciente, previo consentimiento informado. Se describen las características clínicas, el enfoque inicial, los hallazgos endoscópicos y la similitud con otras patologías, para terminar con una revisión del tema en la literatura. La tuberculosis gástrica simuló, inicialmente, otras patologías, lo que generó retraso y algunas dificultades en el diagnóstico y manejo. Se trata de una entidad con manifestaciones clínicas variables e inespecíficas, que se confunden con otras entidades, dada su similitud clínica y poca frecuencia de presentación. Existe poca literatura y la mayoría se limita a reportes de casos aislados, con comportamiento benigno y respuesta adecuada al manejo médico con fármacos antituberculosos.

Gastrointestinal tuberculosis is a rare entity that mimics other pathologies. It is commonly associated with late diagnosis due to its clinical characteristics and atypical presentation in these types of organs. Data were taken from the medical record of a patient following informed consent. Clinical characteristics, initial focus, endoscopic findings, and similarities with other pathologies are described, and a topic review was done. Initially, gastric tuberculosis mimicked other pathologies causing a delay and difficulty to issue correct diagnosis and treatment. This entity has variable and nonspecific clinical manifestations which can be confused with other entities due to clinical similarities and infrequent presentation. There is scarce literature and most is limited to isolated case reports with benign behavior and adequate response to TB treatment.

A tuberculose gástrica é uma entidade rara que simula outras patologias. Acostuma associar-se com diagnósticos tardios devido a suas características clínicas e forma de apresentação atípica neste tipo de órgãos. Se extraíram os dados da história de uma paciente, prévio consentimento informado. Se descrevem as características clínicas, o enfoque inicial, os descobertas endoscópicos e a similitude com outras patologias, para terminar com uma revisão do assunto na literatura. A tuberculose gástrica simulou, inicialmente, outras patologias, o que gerou retraso e algumas dificuldades no diagnóstico e manejo. Se trata de uma entidade com manifestações clínicas variáveis e inespecíficas, que se confundem com outras entidades, dada sua similitude clínica e pouca frequência de apresentação. Existe pouca literatura e a maioria se limita a reportes de casos isolados, com comportamento benigno e resposta adequada ao manejo médico com fármacos antituberculosos.

Intussuscepção colônica em adulto: relato de caso / Adult colonic intussusception: a case report

Intussuscepção é a penetração de um segmento do tubo gastrintestinal (TGI) em direção ao segmento adjacente. É rara em adultos e de diagnóstico difícil. Possui na faixa etária adulta, em geral, um fator precipitante. Este trabalho relata paciente adulta que se apresentou à emergência cirúrgica com abdome agudo. Realizada laparotomia de emergência que evidenciou invaginação colônica. A patologia confirmou tratar-se de lipoma como cabeça do intussuscepto.

Intussusception is the penetration of a digestive tract segment into an adjacent segment. It is rare in adults and difficult to diagnose. For adults it generally involves a precipitating factor. This paper describes an adult patient who entered the emergency department with acute surgical abdomen. Emergency laparotomy revealed colonic intussusception. The pathology confirmed a lipoma as the head of this intussusceptum.

Screening main genes during mesenchymal stem cell transplantation in repair of inflammatory bowel tissue / 中国组织工程研究

BACKGROUND:Previous studies have verified that mesenchymal stem cells could be transplanted into inflammatory bowel mucosa to repair inflammatory bowel tissue. OBJECTIVE:To observe the differential gene expression in large intestine before and after mesenchymal stem celltransplantation in repair of inflammatory bowel tissue of rats using microarray technology, and to primarily discover the main genes during mesenchymal stem celltransplantation, differentiation, and reparation in inflammatory colorectal tissue region. METHODS:Healthy Sprague-Dawley rats were randomly divided into two groups. Experimental rat models of inflammatory bowel disease were established using trinitrobenzene sulfonic acid via enema. At 24 hours after model establishment, green fluorescent protein-labeled mesenchymal stem cells were infused via the caudal vein. The control group was treated with physiological saline by enema, instead of trinitrobenzene sulfonic acid. At 28 days, large intestine was obtained from the experimental group and control group. Differential y expressed genes were screened in the experimental and control groups using microarray technique. RESULTS AND CONCLUSION:The microarray analysis results showed that there were 388 differential genes in the control and experimental groups (P2), in which 191 were up-expressed, and 197 were down-expressed. Al of these genes were mainly involved in inflammatory reaction, immune reaction and celldifferentiation. In the top 10 up-regulation and down-regulation differential genes (total y 20 genes), 3 genes were involved in inflammation, 3 genes were involved in immune reaction, and 2 genes were related to stem celldifferentiation. In the 388 genes, 33 were related to signaling pathways (P<0.05), 6 related to inflammation, 8 related to immunity, and 5 related to stem celldifferentiation. Results suggested that the main genes involved in mesenchymal stem cells in repair of inflammatory bowel tissue were primarily screened using gene expression microarray technique.

Correlation between Bmi-1 and clinicopathological features of colorectal cancer / 中国组织工程研究

BACKGROUND:Bmi-1 (B-cel-specific moloney murineleukemia virus insertion site), a colorectal cancer stem cellgene is of great significance in the regulation of telomere reverse transcriptase activity and transcriptional status as wel as cellaging and carcinogenesis. OBJECTIVE:To investigate the correlation between Bmi-1 expression and clinicopathological changes of colorectal cancer. METHODS:The expression of Bmi-1 mRNA in carcinoma cells was detected in 50 cases of colorectal cancer using quantitative real-time PCR. The expression of Bmi-1 protein in cancer tissue was detected by hematoxylin-eosin staining and immunohistochemical staining SP method. RESULTS AND CONCLUSION:Sex, age, and tumor size showed no different effects on the expression of Bmi-1 mRNA. The expression of Bmi-1 protein showed no significant difference in patients who were different in sex, age, tumor size and Duke staging of tumor. The expressions of Bmi-1 mRNA and protein in patients with lymph node metastasis and depth of invasion deeper than the serosa were much higher than those in patients with no lymph node metastasis and depth of invasion shal ower than the serosa (P<0.05). The expression of Bmi-1 mRNA was much higher in patients with higher Duke staging cancer (P<0.05). The expression of Bmi-1 mRNA and protein are closely related to different pathological features of colorectal cancer, such as metastasis, infiltration, and Duke staging.

Effects and Significance of SDF-1/CXCR4 in Proliferation, Migration and Invasion of Colorectal Cancer Cell Line SW480 / 天津医药

Objective To discuss the influence and significance of stromal cell-derived factor 1 (SDF-1) and its specific receptor CXC chemokine receptor 4 (CXCR4) in proliferation, migration and invasion ability of SW480 colorectal cancer cells. Methods The colorectal cancer cell line SW480 in logarithmic phase was divided into four groups:control group (with no any processing), SDF-1 group (added 100μg/L SDF-1), SDF-1+1 mg/L AMD3100 mixed group (added 1 mg/L AMD3100 for 2 hours, then added 100μg/L SDF-1) and AMD3100 group (added 1 mg/L AMD3100). Immunohisto?chemistry method was used to detect the protein expression of CXCR4 in SW480 cells. The expression of CXCR4 mRNA in SW480 cells was detected by RT-PCR before and after SDF-1 and AMD3100 treatment. MTT assay and transwell chamber were used to test the changes of proliferation, migration and invasion ability of SW480 cells before and after SDF-1 and AMD3100 treatment. Results The result of immunohistochemistry showed that CXCR4 protein was expressed in SW480 cells (positive rate=80%). CXCR4 mRNA was expressed in SW480 cells. The expression of CXCR4 mRNA was up-regulat?ed by SDF-1(100μg/L), which could be inhibited by AMD3100 (1 mg/L). The proliferation activity was higher in SDF-1 group (0.847±0.039) compared to that in control group (0.624±0.011) and SDF-1+AMD3100 mixed group (0.607 ±0.016). The proliferation activity was lower in AMD3100 group (0.456 ± 0.031) than that in control group and SDF-1+AMD3100 mixed group (F=108.03, P<0.05). The number of transmembrane cells was more in SDF-1 group (98.7±5.8, 33.7±6.2) than that in control group (21.0±2.2, 6.1±2.3), SDF-1+1 mg/L AMD3100 mixed group (18.5±8.4, 8.5±2.8) and AMD3100 group (12.1±3.2, 2.1±1.0) detected by transwell chamber experiment. However, there were no statistical differences between three groups. Conclusion The biological axis SDF-1/CXCR4 can promote the proliferation, migration and invasion in colorectal cancer cell line SW480.

Multi-slice spiral computerized tomography findings of colorectal cancer with chronic schistosomiasis / 中华传染病杂志

Objective To retrospectively analyze computerized tomography (CT) imaging features of colorectal cancer with chronic schistosomiasis in order to improve the diagnostic accuracy.Methods Eighty patients whose diagnosis was pathologically confirmed as colorectal cancer with schistosomiasis were collected from Tongji Hospital and Kunshan Chinese Medicine Hospital from January 2007 to December 2012.All the patients underwent abdominal plain CT and contrast-enhanced CT scan.The lesion location,morphology,size,calcification features,enhancement patterns and cancer metastasis were evaluated and compared by two radiologists who were blind to the diagnosis.Twenty colorectal cancer cases without schistosomiasis from the same area were also collected as controls.Results CT imaging showed that the tumors all occurred in the colon and rectum in 80 patients,mainly in colon descendens,colon sigmoideum and rectum.The lesion was characterized by irregular bowel wall thickening with soft tissue masses,and the average length of impaired intestine was (21.35 ± 4.50) cm.The lesions were solitary in 68 cases (85.0％) and were multifocal in 12 cases (15.0％).Linear,spotty and small patchy calcifications were seen in all the patients,with margins unclear in 59 patients (73.8％) and margins clear in 21 patients (26.2％).Early phase enhancement was seen in 68 cases (85.0％),of which 45 cases (56.2％) had homogenous enhancement and 23 cases (28.8％) had heterogeneous enhancement.Late phase enhancement was seen in 73 cases (91.2％) and necrosis was hardly seen.Only two cases (2.5％) had liver metastasis without lymphatic metastasis.All the 20 colorectal cancer cases without schistosomiasis presented with single lesion,which was characterized by irregular bowel wall thickening and local ulcer.The average length of impaired intestine was (6.90±3.40) cm.No calcification was seen in these lesions.All cases had early phase lesion with remarkable heterogeneous enhancement with low density necrotic area.The late phase enhancement was decreased.Four cases (20.0％) had liver metastasis.Compared to cases without schistosomiasis,cases with schistosomiasis tended to have multifocal (x2=100,P=0.000) and longer lesion (t=45.506,P=0.000),and more calcification (x2=100,P=0.000).The early phase heterogeneous enhancement was less frequent (x2 =88,P=0.000) and late phase enhancement was more frequent (x2=100,P=0.000).The liver metastasis rate was significantly lower (x2 =8.688,P =0.014).Conclusions The CT imaging of colorectal cancer with schistosomiasis is characterized by calcifications inside the tumor with obscured margins and multiple intestinal segments involvement.Hematogenous metastasis and lymphatic metastasis are rarely seen.

Imunoexpressão das proteínas COX-2, p53 e caspase-3 em adenoma colorretal e mucosa não neoplásica / Immunoexpression of the COX-2, p53, and caspase-3 proteins in colorectal adenoma and non-neoplastic mucosa

OBJETIVO: Analisar a imunoexpressão das proteínas COX-2, p53 e caspase-3 em adenomas colorretais e na mucosa não neoplásica. MÉTODOS: Foram submetidos à colonoscopia 72 indivíduos que forneceram 50 amostras de adenomas e 45 de mucosa colorretal não neoplásica. Os tecidos foram obtidos pela técnica de arranjo em matriz (tissue microarray) e submetidos a estudo imunoistoquímico com anticorpos primários p53, COX-2 e caspase-3. A positividade e intensidade da imunorreação foram classificadas. Foram estudadas as seguintes variáveis: localização do adenoma no colo, grau de displasia, tamanho, e escores de positividade e intensidade da imunoexpressão das proteínas p-53, caspase-3 e COX-2. RESULTADOS: Nos adenomas, a imunoexpressão da proteína p53 mutada foi positiva em 30 (60%) e negativa em 20 (40%) amostras. Na mucosa colorretal não neoplásica, a imunoexpressão da proteína p53 mutada foi negativa em 39 (86,6%) amostras e positiva em 6 (13,3%) (p<0,0001). Houve diferença significativa entre o maior tamanho (p=0,006) e o maior grau de displasia dos adenomas (p<0,0001) e a intensidade de imunoexpressão da proteína p53 mutada. A positividade e intensidade da imunoexpressão das proteínas COX-2 (p=0,14) e caspase-3 (p=0,23), nos adenomas e na mucosa colorretal não neoplásica, não apresentaram diferença significante. CONCLUSÃO: A proteína p53 mutada é hiperexpressada nos adenomas em comparação com a mucosa não neoplásica. Nos adenomas, o maior tamanho e o maior grau de displasia foram associados à maior expressão da proteína p53 mutada. A imunoexpressão das proteínas COX-2 e caspase nos adenomas não apresentou correlação com os aspectos anatomopatológicos e não foi diferente em termos de níveis de expressão correspondentes na mucosa não neoplásica.

OBJECTIVE: To analyze the immunoexpression of the COX-2, p53, and caspase-3 proteins in colorectal adenomas and non-neoplastic mucosa. METHODS: 72 individuals were subjected to colonoscopy, which provided 50 samples of adenomas and 45 samples of non-neoplastic colorectal mucosa. The tissue samples were obtained via the tissue microarray technique and subjected to immunohistochemical analysis using primary anti-p53, anti-COX-2, and anti-caspase-3 antibodies. The positivity and intensity of the immunoreaction were classified. The analyzed variables were as follows: site of the adenomas in the colon, degree of dysplasia, size, and score of positivity and intensity of immunoexpression of the p-53, caspase-3, and COX-2 proteins. RESULTS: The immunoexpression of mutated protein p53 was positive in 30 (60%) adenoma samples and negative in 20 (40%) adenoma samples. The immunoexpression of mutated protein p53 was negative in 39 (86.6%) samples and positive in 6 (13.3%) samples of the non-neoplastic colorectal mucosa (p<0.0001). Significant differences were seen between both the largest size (p=0.006) and the highest degree of dysplasia (p<0.0001) of the adenomas and the intensity of immunoexpression of mutated protein p53. The positivity and intensity of immunoexpression of COX-2 (p=0.14) and caspase-3 (p=0.23) showed no significant differences between the adenomas and the non-neoplastic colorectal mucosa. CONCLUSION: Mutated protein p53 was hyperexpressed in the adenomas compared with the non-neoplastic mucosa. Greater size and greater degree of dysplasia in the adenomas were associated with higher expression of mutated protein p53. The immunoexpression of COX-2 and caspase-3 in the adenomas did not exhibit a correlation with the anatomical-pathological features of the tumors and did not differ from the corresponding expression levels in the non-neoplastic mucosa.

The jejunoileal bypass provokes morphological changes in the large intestine? An experimental study in rats / A derivação jejuno-ileal provoca alterações morfológicas no intestino grosso? Estudo experimental em ratos

PURPOSE: To analyse histopathological alterations characterized by the mitotic index in the mucosa of the large intestine in Wistar rats submitted to jejunoileal bypass operation after continued administration of sodium nitrite and vitamin C to different groups. METHODS: Eighty male Wistar rats were employed and separated into 12 groups. In the control group (20 rats): five animals ingested only water; five animals received vitamin C; five animals received sodium nitrite and five received sodium nitrite + vitamin C. In the sham group (20 rats), the animals were anesthetized and underwent midline laparotomy and only intestinal manipulation was performed: five animals ingested only water; five animals received vitamin C; five animals received sodium nitrite and five received sodium nitrite + vitamin C. In the operated group 40 rats underwent a jejunoileal bypass surgery: ten animals ingested only water; ten animals received vitamin C; ten animals received sodium nitrite and ten received sodium nitrite + vitamin C. The mean weight of the animals was measured weekly. The large intestine was subdivided into cecum (S1), ascending colon (S2), transverse colon (S3), descending colon (S4) and rectum (S5) for histopathological analysis and mitotic counts. The statistical analysis was used to compare the mitotic indices. The level of significance was 5%. RESULTS: The mean of all the segments indicates that the sodium nitrite+vitamin C group obtained the lowest mitotic index compared to the other treatments in the control group. The segments S1 and S2 showed a statistical difference with the vitamin C treatment: a higher mitotic index and better preservation of the mucosa in the operated group. In the sham group the main statistical difference occurred only in the sodium nitrite+vitamin C group between the means of the segments. CONCLUSIONS: The comparison of all the colonic segments of the various groups revealed a lower mitotic index in the animals treated with sodium nitrite+vitamin C. In addition, it was found that vitamin C did not present a statistically significant inhibiting effect on the preservation of the mucosa and the mitotic index.

OBJETIVO: Analisar as alterações histopatológicas caracterizada pelo índice mitótico na mucosa do intestino grosso em ratos Wistar submetidos a operação de bypass jejunoileal após a administração continuada de nitrito de sódio e vitamina C para diferentes grupos. MÉTODOS: Oitenta ratos Wistar foram utilizados e separados em 12 grupos. No grupo controle (20 ratos): cinco animais ingeriram apenas água; cinco animais receberam vitamina C, cinco animais receberam nitrito de sódio e cinco receberam nitrito de sódio + vitamina C. No grupo sham (20 ratos), os animais foram anestesiados e submetidos a laparotomia mediana e só a manipulação intestinal foi realizada: cinco animais ingeriram apenas água; cinco animais receberam vitamina C, cinco animais receberam nitrito de sódio e cinco receberam nitrito de sódio + vitamina C. No grupo operado 40 ratos foram submetidos a uma cirurgia de bypass jejunoileal: dez animais ingeridos apenas água; dez animais receberam vitamina C, dez animais receberam nitrito de sódio e dez nitrito de sódio + vitamina C. O peso médio dos animais foi medido semanalmente. O intestino grosso foi subdividido em ceco (S1), cólon ascendente (S2), cólon transverso (S3), cólon descendente (S4) e reto (S5) para análise histopatológica e contagem das mitoses. A análise estatística foi utilizado para comparar os índices mitóticos. O nível de significância foi de 5%. RESULTADOS: A média de todos os segmentos indica que o grupo que ingeriu nitrito de sódio + vitamina C obteve o menor índice mitótico em relação aos demais tratamentos no grupo controle. Os segmentos S1 e S2 mostraram uma diferença estatística com a vitamina C de tratamento: um maior índice mitótico e melhor preservação da mucosa no grupo operado. No grupo sham a principal diferença estatística ocorreu apenas no grupo que ingeriu nitrito de sódio + vitamina C entre as médias dos segmentos. CONCLUSÕES: A comparação de todos os segmentos do colon dos vários grupos revelaram um menor índice de mitose nos animais tratados com nitrito de sódio + vitamina C. Além disso, a vitamina C não apresentou efeito inibidor, estatísticamente significativo, na preservação da mucosa e do índice de mitoses.

Comparative study of computer tomography presentations and pathological results of chronic intestinal schistosomiasis / 中华传染病杂志

ObjectiveTo retrospectively analyze the abdominal computer tomography (CT)findings and pathological results of chronic intestinal schistosomiasis in order to improve the diagnostic accuracy of the disease.MethodsThe plain plus enhanced CT scanning was performed in 56 cases (male 37,female 19; mean age 69.2 years).All cases confirmed by pathological examination.The location,shape,size,calcification and pattern of enhancement of lesion were analyzed by two radiological physicians independently.ResultsThe colon wall of all 56 cases was presented with thickening (0.3-1.2 cm) by CT scanning,among which,43 (76.8％) were presented with welldistributed thickening.The calcification of colon wall included linear calcification (n=42),tram-like calcification (n=19) and spot calcification (n=8).The margin of calcification was clear.The locations of calcification in colon were as follows:whole colon (n =5 ),ascending colon (n =9 ),transverse colon (n=12),descending colon (n =24),rectosigmoid (n=34) and rectum (n=30).There were 17 cases presented with severe calcification.The pathological examinations confirmed that linear and tram-like calcification resulted from calcified ova deposited in submucous,subserosa. In 8 cases with spot calcification and 17 with severe calcification,there were calcified ova deposited in all layers of colon wall,accompanied by chronic inflammation,polyp and schistosomiasis granuloma.There were 5 cases complicated by adenocarcinoma.ConclusionsCT scanning is an important imaging method in the diagnosis of chronic intestinal schistosomiasis,with the distinguishing presentation of well-distributed thickening and calcification in the colon wall.When irregular thickening,mass or nodular are found in the colon wall of patients with chronic intestinal schistosomiasis,colorectal carcinoma should be highly suspected.

The clinical research of multi-slice spiral CT in intestinal imaging / 中华放射学杂志

Objective To investigate the value and usefulness of optimized multislice CT enterography (MSCTE) with orally administered isosmotic mannitol (2. 5%) as negative contrast in demonstrating the small bowel and its abnormality. Methods Forty patients suspected of intestinal tumors were randomly divided into two groups and underwent conventional or optimized MSCTE. The expansion degree of bowel lumen and the thickness of bowel wall were evaluated for the six segments of the small intestine. The other 20 patients suspected of gastrointestinal diseases underwent gastrointestinal CT imaging.The expansion degree of bowel lumen and the wall thickness of bowel wall were statistically analyzed with Chi-Square test and t test. Results The wall thickness of the stomach, ileum and colon were (2. 56 ±0.52) ,(1.41 ±0. 15),(1.46 ±0. 13),(1.91 ±0. 25), (1.97 ±0.26),(2.01 ±0. 19), (2. 04 ±0.24)and (2. 05 ±0. 18)mm. Optimized method was superior to conventional method in the expansion degree of the second and third segments of the small intestine (P ＜ 0. 05) . There was no significant differences between two groups in the expansion degree and depiction of mucosa for the other segments of small intestine (P ＞ 0. 05). The gastrointestinal CT imaging was poor in the depiction of the duodenum and jejunum, but stomach, ileum and colon were fully illustrated. Conclusion Optimized MSCTE was superior to conventional method in demonstrating the small bowel, and gastrointestinal CT imaging can expand diagnostic scope because of good observation of whole gastrointestinal tract.

Laparoscopic proctosigmoidectomy for cavernous hemangioma of the colorectum / 中华普通外科杂志

Objective To study the clinical characteristic and treatment of colorectal cavernous angioma and laparoscopic proctosigmoidectomy in colorectal cavernous angioma. Methods Clinical data of 8 colorectal cavernous angioma cases were analyzed. Results Cavernous hemangioma located in the rectum in 4 cases,in the proctosigmoid in 3 cases,and in the proctosigmoid and descending colon in one case.Under definite diagnosis,all cases underwent laparoscopic colorectomy,the postoperative recovery was satisfactory,and there was no postoperative mortality. Conclusions Colorectal cavernous angioma is rare,and usually be misdiagnosed.It commonly involves sigmoid and rectum.Laparoscopic proctosigmoidectomy is an effective way to deal with the disease.

Comparing three screening schemes of colorectal cancer in general population / 中华健康管理学杂志

Objective Comparing three screening schemes of colorectal cancer in general population to provide scientific basis for coiorectal cancer screening in communities. Methods Questionnaire screening among high-risk population and immunoassay fecal occult blood test (FOBT) were used for colorectal cancer detection. Colonescopy and pathological test were considered as gold standard of screening results. Results Nine coloreetal cancers and 796 colorectal adenomas were detected in 68 953 participants. Mean onset age of coloreetal adenoma was 7. 7 years earlier than colorectal cancer. For questionnaire and FOBT,the sensitivity was 44.4% ,77.8% and 100.0% ,while the specificity was 98.6%, 95.5% and 94.4%, respectively. The Youden index of questionnaire, FOBT, and questionnaire-FOBT sequential method was 0.4,0.7,and 0.9,and the likelihood ratio ( +/- ) was 32.7/0.6,17. 2/0.2,and 17.8/0.0,respectively. When 50 was used as initial age of screening, screening receivers accounted for 9.7% ,and 66. 7% colorectal cancer could be detected. When 40 was used as initial age of screening, screening receivers and cost increased by 57.1% ,and only 11.1% more patients with colorectal cancer could be detected. Conclusions Questionnaire-FOBT sequential method has high sensitivity and specificity of colorectal cancer screening. Screening at 50 year-old may be better for community residents. The time of colorectal adenoma developed to colorectal cancer is about 8 years.

Case control study of the correlation between obesity and colorectal adenoma / 中华消化内镜杂志

Objective To investigate the association between body mass index(BMI),waist circumference(WC),waist hip ratio(WHR) and the risk of colorectal adenoma,which was considered as a precancerous lesion.Methods Subjects aging from 25 to 88 years old who underwent colonoscopy at Tongji Hospital from December 2006 to December 2007 were selected and assigned into the adenoma group( n =250) and the control group(n=289) according to the findings of the colonoscopy.The body height,weight,waist and hip circumference of every subject were measured respectively.The logistic multi-factors regression analysis was applied to analyze the data.Results When obesity was determined by BMI or WC,the risk of adenorrm in pure obesity group and abdominal adiposity group was 2.48(95%CI = 1.19～5.20,P<0.05) and 1.75(95%CI=1.15～2.66,P<0.01 ),respectively.The corresponding value in male was 4.10(95%CI = 1.26～13.31,P<0.05) and 1.70(95%CI = 1.00 -2.88,P<0.05).The risk of advanced and non-advanced adenoma in pure obesity was 2.71(95%CI=1.01～7.29,P<0.05 ) and 2.39(95%CI=1.05～5.47,P<0.05) ; the risk of non-advanced adenonm in abdominal adiposity group was 2.03(95%CI=1.25～3.28,P<0.01),but no significant difference in risk of advanced adenoma was detected.When obesity was determined by WHR,no significant difference was found in any regarding.Conclusion Obesity and abdominal adiposity are associated with the risk of colorectal adenoma,beth advanced and non-advanced,which is more obvious in male.

Expression of protein kinase C in multidrug resistant cells of colorectal carcinoma / 吉林大学学报(医学版)

Objective To detect the expression of protein kinase C(PKC) in multidrug resistant cells of colorectal carcinoma after ionizing irradiation and observe the effect of PKC on occurrence and development of the multidrug resistant.Methods The effect of PKC on multidrug resistant HCG-8 cells of colorectal carcinoma after treated with X-ray was detected by indirect immunofluorescence technique and flow cytometry.Results Compared with sham-irradiation group,the positive percentage of PKC was increased significantly(P

The analysis of 20 misdiagnosed cases of large intestine tuberculosis / 中华消化杂志

Objective To summarize the complication of clinical characteristics, factors causing misdiagnosis, and diagnosis of large intestine tuberculosis (LIT). Methods The data of twenty cases of LIT misdiagnosed preoperatively in our hospital were analyzed retrospectively. The difficulties of LIT diagnosis and management were studied and analyzed. Results Abdominal pain, mass, and the alteration of stool habit were the most common symptoms. LIT was most commonly confused with malignant tumor, Crohn's disease, and periappendicular abscess. Ten of 17 patients, who were performed exploratory laparotomy, were misdiagnosed as tumor or Crohn's disease. Most of our cases were not definitively diagnosed until the histopathologic examination after surgery. Three cases were diagnosed by other methods. Gastrointestinal X ray series, colonoscopy, endoscopic fine needle aspiration cytology(FNAC) and laparoscopic exploration may improve the diagnosis. Exploratory laparotomy with biopsy was the final procedure for diagnosis. Final diagnosis mainly depends on histology. Conclusions LIT lacks special clinical manifestations and has a high misdiagnosis rate. But if correct diagnosis is established, most patients can be cured and unnecessary exploratory laparotomy can be avoided. Six months antituberculosis treatment is effective for LIT whether the lesion is excised or not.