Relationship between Quality of Life and Oral Health Status of Patients with Chronic Liver Disease

ABSTRACT Objective: To investigate the relationship between the quality of life and work ability related to the oral health status of patients with chronic liver diseases. Material and Methods: The sample size contains all patients referred to the internal ward of Afzalipour and Bahonar hospitals due to chronic liver disease from 2019 to 2020. Patient selection was based on a simple census and a questionnaire that contained characteristics information of the patient, Work Ability Index questionnaire and SF-36 questionnaire were completed by the patients and some information was extracted from medical file. The SF-36 questionnaire assesses the quality of life in two general dimensions (physical health and mental health) with the physical function subscale. DMFT, Gingival index, and Periodontal disease index are used to evaluate the severity and extent of gingivitis and periodontitis. For data analysis, ANOVA, Spearman correlation coefficients were used and the significant level was p<0.05. Results: a total of 108 patients were examined. The mean age of participants was 41.2 ± 4.3 years. The DMFT index in patients was also reported as 22.6 ± 7.35. Also, 32.4% of people described their ability to do work as poor, 21.3% as good, and 7.4% as excellent. Patients with poor or moderate workability reported a higher index of DMFT. Among the participants, 61 and 21 patients had gingivitis and periodontitis, respectively. Mean results of total SF-36 indices were reported at a low level in patients with increased DMFT and gum diseases. Patients with poor or moderate workability had a higher index of DMFT. There was a significant relationship between these two variables (p=0.001). However, they were not significantly associated with periodontitis. Conclusion: There was a significant relationship between the SF-36 index, the ability to work and the type of liver disease.

Applications of artificial intelligence in major gastrointestinal diseases in elderly patients / 中华老年医学杂志

Gastrointestinal tumors(GT)are characterized by both high malignancy and high mortality and have become the major diseases for prevention in the elderly.GT often present detectable changes, including bleeding and abnormal mucosal morphology.However, many technical difficulties remain in accurately monitoring the tumor itself and related abnormal lesions mentioned above, which are the key factors affecting the early detection rate of gastrointestinal tumors.In recent years, with progresses in artificial intelligence(AI)applications for digestive endoscopy image analysis, biosensors, new biomarkers and other areas, AI holds promise for the detection of bleeding, morphological and structural abnormalities of the mucosa, tumors and other major disorders.Here we review the progress of AI applications in geriatric digestive diseases affecting digestive organs and the mucosa in light of morphology and function, to provide a reference for reducing the incidence of both geriatric emergencies and GT.

Valoración del comportamiento de factores causales del sangrado digestivo infantil / Assessment of the behavior of causal factors in infant gastrointestinal bleeding

RESUMEN Introducción: el sangrado del tubo digestivo es infrecuente en pediatría. Aunque la mayoría de las causas no ponen en peligro la vida, se requiere un enfoque que permita al médico realizar un diagnóstico temprano y valorar la severidad del sangrado, así como la selección de estudios complementarios diagnósticos y terapéuticos. Objetivo: valorar el comportamiento clínico que presentan los factores causales de sangrado digestivo infantil en el Hospital Pediátrico Provincial Docente de Pinar del Río, durante el periodo 2019- 2021. Métodos: estudio observacional, descriptivo y transversal en una muestra constituida por 49 niños, seleccionados mediante un muestreo aleatorio simple y que cumplieron con los criterios de inclusión. La aplicación de una encuesta permitió la obtención de información que dio salida a las variables estudiadas. Para el análisis de los resultados se utilizaron los métodos de la estadística descriptiva, como las frecuencias absolutas y relativas. Resultados: predominó el grupo etareó de uno a cinco años (44,9 %). Se identificaron como factores de riesgo fundamental la dieta inadecuada (43,3 %) y la constipación (40,0 %). Predominó el sangrado digestivo bajo (84,3 %), donde la fisura anal (24,2 %) y los pólipos de recto (16,1 %) fueron las causas principales. Conclusiones: se presenta con mayor frecuencia en el menor de cinco años, en la zona urbana, la rectorragia y la hematemesis fueron las principales manifestaciones clínicas, predomina en sangrado digestivo bajo con la fisura perianal y los pólipos como causas principales.

ABSTRACT Introduction: gastrointestinal tract bleeding is infrequent in pediatrics. Although most of the causes are not life-threatening, it requires an approach that allows the physician to make an early diagnosis and assess the severity of the bleeding, as well as the selection of complementary diagnostic and therapeutic studies. Objective: to assess the clinical behavior presented by the causal factors of digestive bleeding in children at Provincial Pediatric Teaching Hospital of Pinar del Río, during the period 2019- 2021. Methods: an observational, descriptive and cross-sectional study in a sample comprised of 49 children chosen by means of a simple random sampling and having the inclusion criteria. The application of a survey allowed the collection of information to analyze the variables studied. For the analysis of the results, descriptive statistical methods such as absolute and relative frequencies were applied. Results: the group aged one to five years was predominant (44,9%). Inadequate diet (43,3 %) and constipation (40,0 %) were identified as basic risk factors. Lower gastrointestinal bleeding predominated (84,3 %), with anal fissure (24,2 %) and rectal polyps (16,1 %) as the main causes. Conclusions: it occurs more frequently in children under 5 years old, in the urban area, rectorrhagia and hematemesis were the main clinical symptoms and signs, lower gastrointestinal bleeding predominated with perianal fissure and polyps as main causes.

Clinical characteristics and risk factors of gastrointestinal involvement in patients with systemic lupus erythematosus / 中华风湿病学杂志

Objective:To study the clinical features and prognostic risk factors of gastrointestinal (GI) involvement in systemic lupus erythematosus (SLE), and improve clinicians' understanding of GI involvement in SLE.Methods:The clinical data of SLE patients admitted to the First Affiliated Hospital of Guangxi Medical University from September 1, 2012 to September 1, 2019 were retrospectively analyzed. Two hundred and forty-three patients with GI system involvement were the GI system affected group, and 486 patients with-out GI system involvement at the same period were randomly selected as the control group. The clinical mani-festations, laboratory tests and treatment effects of the two groups were compared by t test, Wilcoxon signed-rank test and χ2 test and Logistic regression was used to analyze the prognostic risk of SLE with GI system involvement. Results:① There were 243 SLE patients with GI involvement, with the proportion of GI involvement in SLE patients of 6.4%(243/3 820), and as the first manifestation with GI system symptoms accounted for 20.2%(49/243). The common causes were lupus hepatitis accounted for 52.3%(127/243), lupus mesenteric vasculitis (LMV) for 35.0%(85/243), pseudo Intestinal obstruction (IPO) for 9.9%(24/243), lupus-related pancreatitis for 8.6%(21/243), and protein-losing enteropathy (PLE) as 7.0%(17/243). ② Compared with the control group, the group with GI involvement had a lower average age [(38±14) year vs(32±15) year, t=-2.47, P=0.014], a shorter median duration of illness [12.0(3.0, 72.0) months vs 5.0(1.1, 24.8) months, Z=-5.67 , P<0.001], a higher median systemic lupus erythematosus disease activity index (SLEDAI) score [10(6,28) vs 16(9, 37), Z=2.24 , P<0.001], the occurrence of skin rash (38.7% vs 53.5%, χ2=14.46), arthritis (36.4% vs 46.7%, χ2=7.12 , P=0.008), myositis (43.0% vs 56.4%, χ2=11.53 , P=0.001), pericarditis [(216±111)×10 9/L vs (175±114)×10 9/L, t=-4.69 , P<0.001], thrombocytopenia, and hydroureterosis (1.0% vs 12.8%, χ2=47.47 , P<0.001) were high, but the incidence of pulmonary arterial hypertension (PAH) (31.2% vs 10.7%, χ2=36.99 , P<0.001) was low; Serum alanine aminotransferase (ALT) [17(10, 29) U/L vs 59(16, 127) U/L, Z=9.65 , P<0.001], aspartate aminotransferase (AST) [25.0 (18.0, 37.0) U/L vs 82.5(25.0, 289.0) U/L, Z=10.57 , P<0.001], alkaline phosphatase (ALP) [58(46, 76) U/L vs 82(56, 187)U/L, Z=8.42 , P<0.001], Creatine kinase (CK) [44.0(28.0, 83.0) U/L vs 58.5(34.0, 176.0) U/L, Z=4.46 , P<0.001], lactate dehydrogenase (LDH) [(309±206) U/L vs (443±332) U/L, t=5.64 , P<0.001], fasting blood glucose (FBS) [(5.0±1.5) mmol/L vs (5.3±1.7) mmol/L, t=2.16 , P=0.031], triglyceride (TG) [(2.0±1.3) mmol/L vs (2.7±2.2) mmol/L, t=4.55 , P<0.001] increased, albumin (ALB) [(30±7) g/L vs (27±7) g/L, t=5.87 , P<0.001)] and high-density lipoprotein (HDL) [(1.1±0.8) mmol/L vs (0.9±0.5) mmol/L, t=-4.20 , P<0.001] decrease, and anti SSB antibody positive rate (16.0% vs 9.5%, χ2=5.60 , P=0.018) decreased.③ After 3 months' follow-up, 203 patients with SLE GI involvement were relieved, 30 patients (12.3%) died, and 9 patients (1.8%) died in the control group. Ninety-five (46.8%) patients in the remission group had a significantly higher rate of cyclophosphamide treatment when compared with 5(12.5%) in the non-remission group ( χ2=16.23, P<0.001) . Logistic regression analysis showed that no increase of PAH, elevated erythrocyte sedimentation rate (ESR), ALT, glutamyl transpeptidase (GGT), indirect bilirubin (IBIL) and high SLEDAI scores, hydroureteral dilatation, decreased ALB and HDL were independent related factors for SLE GI involvement, while ascites and elevated FBS were SLE GI involvement factors of poor prognosis. Conclusion:SLE patients with GI involvement have a high mortality rate, and lupus hepatitis and LMV are common. Hydroureterosis, high SLEDAI score, abnormal liver function are risk factors for GI involvement. Jaundice and elevated FBS are the risk factors for poor prognosis, and treatment with cyclophosphamide is the protective factor.

Study on the relation between the common diseases and the constitution of Traditional Chinese Medicine of plateau-related soldiers / 国际中医中药杂志

Objective:To investigate the common diseases and the Constitution of Traditional Chinese Medicine of plateau-related soldiers, and explore the correlation between them.Methods:A total of 271 plateau-related soldiers in our sanatorium from January 1, 2020 to December 31, 2020 were selected as the subjects. All of them were assessed by the TCM constitution scale and the self-designed disease questionnaire and Sociodemographic information.Results:Eighty two percent of 271 plateau-related soldiers were regarded as paranoid constitution and 17.7% were gentleness type. There 73.1% of plateau-related soldiers had one or more diseases, and 90.9% of them were paranoid constitution. There were 47 cases of respiratory diseases, including 2 cases of gentleness type (4.3%) and 45 cases of paranoid constitution (95.7%); 53 cases of digestive system diseases, including 1 case of gentleness type (1.9%) and 52 cases of paranoid constitution (98.1%); 27 cases of skin diseases, including 1 case of gentleness type (3.7%) and 26 cases of paranoid constitution (96.3%); 148 cases of musculoskeletal diseases, including 15 cases of gentleness type (10.1%) and 133 cases of paranoid constitution (89.9%). The digestive system diseases with the highest proportion of paranoid constitution were selected for TCM Constitution correlation analysis, suggesting that there was a correlation between them( χ2=11.32, P<0.01). People including Qi deficiency and phlegm-dampness were more prone to digestive system diseases ( P<0.01). There was a significant negative correlation between gentleness type and digestive system diseases [ OR=0.17, 95% CI(0.040-0.726); P=0.017], as well as Qi deficiency [ OR=4.98, 95% CI(2.717-9.120)] and phlegm-dampness [ OR=12.00, 95% CI(5.269-27.332)]were risk factors for them ( P<0.01). Conclusions:The overall health level of plateau-related soldiers was not optimistic. The digestive system diseases of them were positively correlated with Qi deficiency and phlegm-dampness.

Analysis of CYP2C19 gene polymorphism in patients with upper digestive system diseases in Anhui Province / 预防医学

Objective@#To analyze the CYP2C19 gene polymorphism in patients with upper digestive system diseases in Anhui Province, so as to provide evidence for individual treatment.@*Methods@#The 307 patients with upper digestive system diseases in the Department of Gastroenterology, The 901st Hospital of Combined Service Force of People＇s Liberation Army were selected. The CYP2C19 genotypes were detected by DNA microarray microarray. The CYP2C19 genotypes and metabolic types in different genders, ages and diseases were analyzed.@*Results@# There were 197 males ( 64.17% ) and 110 females ( 35.83% ) , with the age of ( 58.00±16.13 ) years old. The gene frequency of CYP2C19*1, CYP2C19*2 and CYP2C19*3 was 62.70%, 32.25% and 5.05%, respectively. There were 119 cases (38.76%) of *1/*1 ( 636GG, 681GG ), 129 cases ( 42.02% ) of *1/*2 ( 636GG, 681GA ) , 18 cases (5.86%) of *1/*3 ( 636GA, 681GG ) , 29 cases ( 9.45% ) of *2/*2 ( 636GG, 681AA ) , 11 cases ( 3.58% ) of *2/*3 ( 636GA, 681GA ) , and 1 cases ( 0.33% ) of *3/*3 ( 636AA, 681GG ). In terms of metabolisms, there were 119 cases ( 38.76% ) of fast metabolism type, 147 cases (47.88%) of intermediate metabolism type and 41 cases (13.35%) of slow metabolism type. There were no significant differences in CYP2C19 genotypes and metabolic types among the patients with different gender, age and digestive system diseases ( P＞0.05 ).@*Conclusion@#The CYP2C19 genotypes of patients with upper digestive system diseases were polymorphic, mainly the fast metabolism type and the intermediate metabolism type, which could provide reference for the clinical medication of individualized treatment of proton pump inhibitors.

Sangramiento Digestivo Alto. Factores de riesgo asociados. Hospital Carlos Manuel de Céspedes. Enero 2017 a enero 2018 / High Digestive Bleeding Associated risk factors. Carlos Manuel de Céspedes Hospital. January 2017 to January 2018 / Sangramento digestivo alto Fatores de risco associados. Hospital Carlos Manuel de Céspedes. Janeiro de 2017 a janeiro de 2018

RESUMEN Sangramiento Digestivo Alto(SDA) es una emergencia médica frecuente que se asocia a una considerable morbilidad y mortalidad.Se realizó esta investigación con el objetivo de describir el comportamiento de los factores de riesgo asociados al desarrollo del sangramiento digestivo alto, mediante un estudio observacional, descriptivo, longitudinal y retrospectivo, con 40 pacientes que presentaron (SDA), atendidos en el Hospital ¨Carlos Manuel de Céspedes¨ de Bayamo, Granma, en el periodo comprendido entre Enero de 2017 y Enero de 2018. En el estudio predominó el sexo masculino y los pacientes comprendidos entre los 61-80 años de edad. La mayoría eran consumidores de medicamentos sedantes. La causa de sangrado más frecuente fue la gastritis, seguida por la ulcera gastroduodenal. La forma de presentación clínica más habitual lo constituyo la melena.El SDA es más frecuente en el sexo masculino y en pacientes de edad avanzada. Entre sus principales formas de presentación se encuentra la melena y la hematemesis. El consumo de café puede provocar el desencadenamiento de esta patología.

ABSTRACT High Digestive Bleeding (SDA) is a frequent medical emergency that is associated with considerable morbidity and mortality. This research was carried out with the objective of describing the behavior of the risk factors associated with the development of upper digestive bleeding, through an observational, descriptive, longitudinal and retrospective study, with 40 patients who presented (SDA), treated at the ¨Carlos Hospital Manuel de Céspedes¨ from Bayamo, Granma, in the period between January 2017 and January 2018. In the study, male sex and patients between 61-80 years of age predominated. Most were consumers of sedative medications. The most frequent cause of bleeding was gastritis, followed by gastroduodenal ulcer. The most common form of clinical presentation was the mane. SDA is more common in males and in elderly patients. Among its main forms of presentation is the mane and hematemesis. Coffee consumption can cause the triggering of this pathology.

RESUMO Sangramento Digestivo Alto (SDA) é uma emergência médica frequente que está associada a considerável morbimortalidade. Esta pesquisa foi realizada com o objetivo de descrever o comportamento dos fatores de risco associados ao desenvolvimento de sangramento digestivo superior, através de um estudo observacional, descritivo, longitudinal e retrospectivo, com 40 pacientes que apresentaram (SDA), atendidos no Hospital ¨Carlos Manuel de Céspedes¨, de Bayamo, Granma, no período de janeiro de 2017 a janeiro de 2018. No estudo, predominaram o sexo masculino e os pacientes entre 61 e 80 anos de idade. A maioria era consumidora de medicamentos sedativos. A causa mais frequente de sangramento foi gastrite, seguida por úlcera gastroduodenal. A forma mais comum de apresentação clínica foi a crina. SDA é mais comum em homens e em pacientes idosos. Entre suas principais formas de apresentação está a juba e a hematêmese. O consumo de café pode causar o desencadeamento dessa patologia.

Intestinal Microecology in Digestive System Health and Diseases / 胃肠病学

Gastrointestinal tract contains a wide variety of host-specific microbial communities that not only adapt to the unique and diverse environment in the stomach and intestine, but also respond quickly to all kinds of variants from outside of the body. A series of biochemical signals are occurred for interacting with the host to coordinate the exchange of nutrients and regulate the immune function. The interaction between host and microorganisms is based on homeostasis; dysbiosis of intestinal microbiota contributes to the initiation and development of diseases. The relationship between microbes and host from the perspective of microecology, and the relationship between intestinal microecology and digestive system diseases were summarized in this article.

Research on distribution of invention patents of Chinese materia medica for treating high mortality diseases in China--analysis mechanism based on IPC number A61P / 中草药

Based on the International Patent Classification (IPC) A61P, this paper analyzes the distributional therapeutic situation of Chinese materia medica (CMM) in China dynamically and statically from the perspective of invention patent, then the list of 10 groups of A61P with the largest amount of invention patents application and effective amount is compared with the list of high mortality diseases in China, so as to verify the idea whether the R&D focus of CMM is on high mortality diseases, and put forward suggestions for the R&D directions and strategies of CMM in the treatment of high mortality diseases. The research finds that the R&D of CMM mainly focuses on treating high mortality diseases, except for the malignant tumors and mental disorders. In addition, the intellectual achievement of CMM in the treatment of digestive system diseases is the dominant direction. Under the background of internationalization and standardization of CMM, China needs to strengthen the R&D investment direction of CMM in the treatment of malignant tumors, mental disorders and other fields. The quantity and quality advantages of CMM in the treatment of digestive system diseases will be of significance, thus it needs to actively carry out patent distribution abroad. The role of technical evaluation in the cultivation of high-quality and high-value patents should be attached importance.

Prevalencia de desórdenes gastrointestinales funcionales y hábito intestinal en lactantes menores de 12 meses internados en el Hospital Infantil Baca Ortíz de Quito, Ecuador / Prevalence of functional gastrointestinal disorders and intestinal habit hospitalized in infants under 12 months of hospital infantil Baca Ortíz from Quito, Ecuador

Resumen Introducción: la prevalencia de desórdenes gastrointestinales funcionales en niños menores ecuatorianos se desconoce y no hay una prueba estándar para evaluar la consistencia de las heces. Objetivo: determinar la prevalencia de desórdenes gastrointestinales funcionales en lactantes menores a 12 meses e identificar el hábito intestinal. Metodología: estudio de prevalencia en lactantes internados del Hospital Infantil Baca Ortíz de Quito, Ecuador, a quienes se les diagnosticó diarrea funcional, cólico, estreñimiento funcional, disquecia, regurgitación, síndrome de vómito cíclico y rumiación. Fueron incluidas variables sociodemográficas, clínicas y preguntas sobre hábitos intestinales, basados en el Cuestionario para Síntomas Digestivos Pediátricos Roma III traducido y validado en español. Se hizo análisis uni y multivariados y el cálculo de los ORs, siendo una p<0,05 significativa. Resultados: fueron incluidos 147 lactantes, de 6,8±3,3 meses de edad, 50,3% niñas. La principal causa de hospitalización fue del sistema respiratorio. Se reportó 36,0% con algún desorden gastrointestinal funcional: cólico (12,2%), estreñimiento funcional (9,5%), disquecia (8,0%) y regurgitación (7,5%). No hubo factores de riesgo asociados. Se reportaron heces duras en 4,1% y 7,4% por Criterios de Roma III y Escala de Bristol, respectivamente. Hubo concordancia aceptable (kappa=0,3989, p=0,0221) entre el reporte de los padres por los Criterios de Roma III y la Escala de Bristol. Conclusión: un tercio de estos niños presentó algún desorden gastrointestinal funcional, siendo los más frecuentes: estreñimiento funcional, regurgitación, cólico y disquecia; sin posibles factores de riesgo; identificándose una concordancia aceptable entre lo reportado por los padres según los Criterios de Roma III y la Escala de Bristol. MÉD.UIS.2019;32(2):13-21

Abstract Introduction: the prevalence of functional gastrointestinal disorders in Ecuadorian younger infant is unknown and there is no gold standard for stool consistency. Objective: to determine the prevalence of functional gastrointestinal disorders in infants younger 12 months and to identify the intestinal habit. Methodology: prevalence study in hospitalized infants at the Hospital Infantil Baca Ortíz in Quito, Ecuador, who were diagnosed with functional diarrhea, colic, functional constipation, dyschezia, regurgitation, cyclic vomiting syndrome and rumination. Socio-demographic, clinical variables and questions about intestinal habits, based on the Questionnaire for Pediatric Digestive Symptoms Roma III translated and validated in Spanish, were included. The statistic included uni and multivariate analyzes and the calculation of the ORs, being a significant p <0.05. Results: a total of 147 infants, 6,8±3,3 months old, 50,3% girls; with the main cause of hospitalization the respiratory system. Were reported 36.0% with some functional gastrointestinal disorders: colic (12.2%), functional constipation (9,5%), dyschezia (8,0%) and regurgitation (7,5%). There were no possible associated risk factors. Hard stools were reported in 4,1% and 7,4% by Criteria of Rome III and Bristol Stool Scale, respectively. There was acceptable agreement (kappa = 0,3989, p = 0.0221) between the parents' report for the Rome Criteria III and the Bristol Stool Scale. Conclusion: one third of these children presented some functional gastrointestinal disorders, being the most frequent functional constipation, regurgitation, colic and dyschezia; without possible risk factors; identifying an acceptable concordance between what was reported by parents according to Rome Criteria III and Bristol Stool Scale. MÉD.UIS.2019;32(2):13-21

Progress in Research on Application of Artificial Intelligence in Digestive Endoscopy / 胃肠病学

The application of artificial intelligence (AI) in medicine has attracted extensive attention. AI-assisted endoscopic diagnosis is the hot spot of research. The operation of digestive endoscopy is completed by endoscopists in clinical settings, and the diagnosis is completed by endoscopists' eyes along with pathological biopsy findings. It is essentially a process of continuously accumulating experience and gradually perfecting. AI-assisted endoscopic diagnosis is expected to improve the detection rate of digestive tract lesions and reduce missed diagnosis effectively. This article reviewed the role and progress in research on application of AI in endoscopic diagnosis of digestive system diseases.

Advances in Clinical Application of Prebiotics Effect of Lactulose / 胃肠病学

As an osmotic laxative, lactulose has been widely used in the treatment of digestive system diseases. In recent years, with the in-depth study of intestinal microbiota and microecology, the prebiotics effect of lactulose has attracted widespread attention. Exploring the prebiotics effect of lactulose is helpful for the understanding of specific mechanism of disease treatment. This article reviewed the value of prebiotics effect of lactulose in the treatment of digestive system diseases.

Progress in Clinical Research on Microecological Agents for Prevention and Treatment of Digestive System Diseases / 胃肠病学

Gut microflora has been a hotspot in medical and microbiological fields. Especially in the past decade, it has become one of the focuses of life-related research and achieved numerous results. Microecological agent is an important achievement in this field. It has been used in clinical practice for more than 20 years and is mainly used for the prevention and treatment of some digestive system diseases. This article reviewed the progress in clinical research on microecological agents for prevention and treatment of digestive system diseases.

Comparative study on selective hepatic vascular exclsion and total hepatic vascular exclusion for hepatic trauma with major hepatic vein injury / 中华创伤杂志

Objective To compare the effect of selective hepatic vascular exclsion ( SHVE) and total hepatic vascular exclusion ( THVE ) in the treatment of hepatic trauma with major hepatic vein injury. Methods A retrospective case control study was conducted to analyze the clinical data of 42 patients with hepatic trauma accompanied by hepatic vein injury admitted to multiple centers from April 2000 to December 2017. There were 30 males and 12 females, aged 14-65 years [(40. 2 ± 18. 8)years]. Blood flow exclusion was operated through HVE in 22 patients ( SHVE group ) and through THVE in 20 patients (THVE group). SHVE group included 22 patients (16 males and six females), aged (40. 1 ±19. 4)years. There were 10 patients with grade IV and 12 with grade V according to American Association of Traumatic Surgery ( AAST) classification of liver injury. In terms of the hepatic vein injury, there were 13 patients with type I, eight with type III, and one with type IV. THVE group included 20 patients (14 males and six females), aged (39.9 ±18.2)years. There were nine patients with grade IV and 11 with grade V according to AAST classification of liver injury. In terms of the hepatic vein injury, there were 11 patients with type I, seven with type III, and two with type IV. The operation approach, operation time, hepatic warm ischemia time, blocking time of hepatic vein blood flow, amount of abdominal hemorrhage, intraoperative blood loss, postoperative blood loss, intraoperative infusion, total blood transfusion, length of ICU stay after operation, length of hospital stay after operation, function of liver and kidney after operation, incidence of complications and mortality were compared between the two groups. Results There were no significant differences in the amount of abdominal hemorrhage, intraoperative blood loss, postoperative blood loss, perioperative blood transfusion, surgical procedure, and postoperative liver and kidney function between the two groups (P>0. 05). The THVE group had significantly longer operation time, hepatic warm ischemia time, hepatic venous blood flow blocking time, postoperative ICU time and postoperative hospital stay than the SHVE group (P<0. 05). The amount of infusion in the SHVE group was less than that in the THVE group (P <0. 05). The incidence of complications in SHVE group was 27％ (6/22), lower than that in THVE group [60％ (12/20)] (P<0. 05). The mortality of SHVE group was 14％ (3/22), lower than that of THVE group [45％ (9/20)] (P<0. 05). Conclusions SHVE and THVE can effectively control bleeding in the treatment of hepatic trauma with main hepatic vein injury. SHVE has more advantages over THVE in shortening operation time, warm ischemia time of liver, blocking time of hepatic vein blood flow, ICU stay after operation, hospital stay after operation and reducing intraoperative infusion volume, and can reduce the incidence of complications and mortality.

Doenças digestivas em idosos e fatores associados à duração da permanência na unidade Hepatologia e Gastroenterologia do Hospital Universitário de Ensino de Lomé (Togo) / Digestive diseases in elderly and factors associated with length of stay in the hepatology and gastroenterology unit of the campus teaching hospital of lome (togo)

ABSTRACT BACKGROUND: The digestive pathologies are frequent in the elderly and often have a latent and atypical symptomatology. OBJECTIVE: To assess the epidemiological and evolutionary current data on digestive diseases in the elderly, and look for factors associated with length of hospital stay. METHODS: Retrospective study of 10 years, including patients aged 60 and over hospitalized for digestive diseases in the Gastroenterology Department of the Campus Teaching Hospital of Lome, Togo. RESULTS: Of 5933 hospitalized patients, there were 1054 patients (17.8%) aged 60 years and over with a digestive pathology (526 men and 528 women). The average age was 69.5 years ±7.9 ranging from 60 to 105 years. The average length of hospital stay was 7.45 days ±6.2 ranging from 1 to 44 days. HIV prevalence was 2.4%. In order of decreasing frequency, there were hepatobiliary pathologies (54.3%) with a predominance of cirrhosis and liver cancer, eso-gastroduodenal pathologies (23.1%) with predominance of ulcers, gastric cancer and esophageal cancer, intestinal pathologies (8.7%) with a predominance of food poisoning, pancreatic pathologies (4.2%) with a predominance of pancreatic cancer and peritoneal pathologies (1.4%). Gastric cancer was the second digestive cancer found after liver cancer. Pancreatic head cancer was the second disease after gastric cancer which need a transfer in a surgical ward (P=0.031). There were 204 deaths (19.4%). The longest duration of hospitalization was due to gastric cancer (9.16 days). CONCLUSION: Hepatobiliary diseases were the most frequent and associated with a high death rate and a long hospital stay.

RESUMO CONTEXTO: As patologias digestivas são frequentes no idoso e têm geralmente uma sintomatologia latente e atípica. OBJETIVO: Avaliar os dados epidemiológicos e de evolução sobre as doenças digestivas nos idosos, e procurar fatores associados ao período de permanência hospitalar. MÉTODOS: Estudo retrospectivo de 10 anos, incluindo pacientes com idades de 60 ou mais, hospitalizados para doenças digestivas no Departamento de Gastroenterologia do Hospital Universitário de Ensino de Lomé, Togo. RESULTADOS: De 5933 pacientes hospitalizados, havia 1054 pacientes (17,8%) com idade de 60 anos ou mais com uma patologia digestiva (526 homens e 528 mulheres). A idade média foi de 69,5 anos ± 7,9 variando de 60 a 105 anos. A duração média da estadia hospitalar foi de 7,45 dias ±6,2 variando de 1 a 44 dias. A prevalência do HIV foi de 2,4%. Em ordem de diminuição da frequência, houve patologias hepatobiliares (54,3%) com predominância de cirrose e câncer hepático, patologias do esôfago-gastroduodenal (23,1%) com predominância de úlceras, câncer gástrico e câncer esofágico, patologias intestinais (8,7%) com predominância de intoxicação alimentar, patologias pancreáticas (4,2%) com predominância de câncer pancreático e patologia peritoneal (1,4%). O câncer gástrico foi o segundo câncer digestivo encontrado após o câncer de fígado. Câncer de cabeça pancreática foi a segunda doença após o câncer gástrico, que necessitou transferência para a enfermaria cirúrgica (P=0,31). Houve 204 mortes (19,4%). A maior duração da internação foi devido ao câncer gástrico (9,16 dias). CONCLUSÃO: As doenças hepatobiliares foram as mais frequentes e associadas a uma elevada taxa de mortalidade e a uma longa estadia hospitalar.

Brunneroma: reporte de un caso / Brunneroma: a case report

RESUMEN Fundamento: las glándulas de Brunner son estructuras túbulo-acinares ubicadas en la submucosa del duodeno. Su crecimiento excesivo por lo regular no da síntomas o estos son mínimos, lo cual es conocido como adenoma de glándulas de Brunner, hamartoma o brunneroma. Su localización más frecuente es en la primera porción del duodeno y muy raro por debajo de la ampolla de Váter. Objetivo: presentar el caso clínico de un paciente con el diagnóstico de Brunneroma. Caso Clínico: paciente femenina, blanca de 72 años de edad con antecedentes de padecer de úlcera duodenal hace 20 años que ingresa con dolor difuso en abdomen superior acompañado de deposiciones abundantes como borra de café, sudoraciones profusas y pérdida ligera de peso en el último mes. Conclusiones: el Brunneroma es una lesión benigna poco frecuente del duodeno; puede descubrirse de forma accidental y en algunas ocasiones pueden causar hemorragia digestiva.

ABSTRACT Background: The Brunner's glands are tubular structures located in the submucosa of the duodenum. Their excessive growth does not usually give symptoms or at least they are minimum. This is known as Brunner's gland adenoma, Hamartoma or Brunneroma. Its most frequent localization is in the first portion of the duodenum, but it is extremely strange below the ampulla of Vater. Objective: to present the clinical case of a patient with the diagnosis of Brunneroma. Clinical case: white-skinned, 72 years-old, female patient with antecedents of a 20-years duodenal ulcer who is hospitalize with diffuse pain in superior abdomen accompanied by abundant depositions like coffee powder, profuse sweating and slight loss of weight in the last month. Conclusions: Brunneroma is a not very frequent benign lesion of the duodenum; it can be discovered accidentally and in some occasions it may cause digestive hemorrhage.

Evolution of incidence, mortality and cost of nontraumatic abdominal emergencies treated in Brasil in a period of nine years

SUMMARY OBJECTIVE: To evaluate the incidence, mortality and cost of non-traumatic abdominal emergencies treated in Brazilian emergency departments. METHODS: This paper used DataSus information from 2008 to 2016 (http://www.tabnet.datasus.gov.br). The number of hospitalizations, costs - AIH length of stay and mortality rates were described in acute appendicitis, acute cholecystitis, acute pancreatitis, acute diverticulitis, gastric and duodenal ulcer, and inflammatory intestinal disease. RESULTS: The disease that had the highest growth in hospitalization was diverticular bowel disease with an increase of 68.2%. For the period of nine years, there were no significant changes in the average length of hospital stay, with the highest increase in gastric and duodenal ulcer with a growth of 15.9%. The mortality rate of gastric and duodenal ulcer disease increased by 95.63%, which is significantly high when compared to the other diseases. All had their costs increased but the one that proportionally had the highest increase in the last nine years was the duodenal and gastric ulcer, with an increase of 85.4%. CONCLUSION: Non-traumatic abdominal emergencies are extremely prevalent. Hence, the importance of having updated and comparative data on the mortality rate, number of hospitalization and cost generated by these diseases to provide better healthcare services in public hospitals.

RESUMO OBJETIVO: Avaliar a evolução da Incidência, mortalidade e custo das urgências abdominais não traumáticas atendidas nos serviços de emergência do Brasil durante o período de nove anos. MÉTODOS: Este trabalho utilizou informações do DataSus de 2008 a 2016, (http://www.tabnet.datasus.gov.br). Foram analisados número de internações, valor médio das internações (AIH), valor total das internações, dias de permanência hospitalar e taxa de mortalidade das seguintes doenças: apendicite aguda, colecistite aguda, pancreatite aguda, diverticulite aguda, úlcera gástrica e duodenal, e doença inflamatória intestinal. RESULTADOS: A doença que teve o maior crescimento do número de internações foi a doença diverticular do intestino, com o valor de 68,2%. Ao longo dos nove anos não houve grandes variações da média de permanência hospitalar, sendo que o maior aumento foi o da úlcera gástrica e duodenal, com crescimento de 15,9%. A taxa de mortalidade da doença por úlcera gástrica e duodenal teve um aumento de 95,63%, consideravelmente significante quando comparada com as outras doenças. Todas tiveram seus valores de AIH aumentados, porém, a que proporcionalmente teve o maior aumento nos últimos nove anos foi a úlcera gástrica e duodenal, com um acréscimo de 85,4%. CONCLUSÃO: As urgências abdominais de origem não traumática são de extrema prevalência, por isso a importância em ter dados atualizados e comparativos sobre a taxa de mortalidade, o número de internações e os custos gerados por essas doenças, para melhor planejamento dos serviços públicos de saúde.

Research progress of endoscopic techniques in diagnosis and treatment of digestive diseases / 中华消化外科杂志

As an important diagnostic technology for digestive diseases,endoscopic technique has been applied in clinic for nearly 70 years.With the rapid development of science and technology in related disciplines,digestive endoscopy not only is widely used as a diagnostic technique,but also acts as an important role in the treatment of digestive disease.Besides the improvement of traditional treatment techniques,innovative new technologies have emerged,such as endoscopic treatment of gastrointestinal bleeding,endoscopic resection and suture of gastrointestinal lesions,diagnosis and treatment of biliary and pancreatic diseases,and so on,which have become an important treatment of digestive diseases.Since the new century,with the development of artificial intelligence technology and the concept of combining medical and engineering deeply rooted in the hearts of the people,endoscopic techniques have also ushered in new development.

Risk factors of depressive and anxiety symptoms in patients with digestive organic disease / 中国基层医药

Objective To explore the prevalence and possible risk factors of depressive /anxious symptoms of patients with digestive disease .Methods Totally 245 patients with digestive diseases were recruited consecutively .Face-to-face interview and the hospital anxiety and depression scale ( HADS) ,self-rating anxiety scale ( SAS) and self-rating depression scale ( SDS) were employed to collect the clinical data .The non-condition logistic regression was performed to analyze the data .Results The prevalence of depression and anxiety in patients with organic diseases in digestive system was 36.3%.Among them,the higher incidence of depression and anxiety symptoms were digestive system tumors , peptic ulcer , acute pancreatitis and cirrhosis .The educational degree was correlated with simple depression,pure anxiety,depression complicated with anxiety (χ2 =8.781,P=0.013;χ2 =7.976,P=0.018;χ2 =15.807,P=0.003),the degree of high school or above was a protective factor ,the OR values were 0.347, 0.373,0.301.The gender was also correlated with depression ,anxiety,depression complicated with anxiety (χ2 =4.343,P=0.031;χ2 =1.056,P=0.017;χ2 =2.382,P=0.03),female was the risk factor of mental illness ,the OR values were 2.72,2.438,2.671.The age was correlated with depression ,depression complicated with anxiety (χ2 =9.872,P=0.002;χ2 =15.710,P=0.031),the age of over 40 years old was the risk factor of mental illness ,the OR values were 5.137,5.731.The occupation was correlated with depression (χ2 =6.017,P=0.017),the non-physical labor was the risk factors of depression , the OR value was 2.752.Conclusion There is a higher prevalence of depression and anxious symptoms in patients with digestive organic diseases .Female,senior high school or lower ,older than 40 years,and non-manual work are the risk factors of these symptoms .