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Objective To explore the relationship between polyp features at first-time colonoscopy and the recurrence, and to analyze the risk factors of recurrence at different time points of follow-up. Methods The data of 614 patients undergoing colorectal polypectomy between May 2008 and May 2016 were retrospectively analyzed. Patients were classified into 3 groups according to the characteristics and polyp features at first-time colonoscopy. The risk factors influencing polyp recurrence at different time points during follow up were analyzed. Results Univariate analysis showed that age ≥70 years, polyp′s diameter ≥0.5 cm,the number of polyps >2 and distribution throughout colon were risk factors for recurrence. In multivariate models,the number of polyps at baseline was the only significant predictor for recurrence(OR=2.36,95%CI:1.06-5.25). All of 614 patients underwent 6-87 months surveillance colonoscopy. The total recurrence rate was 58.6%(360/614). During four different surveillance intervals including 6-24 months,>24-36 months, >36-48 months, and >48-87 months,the cumulative recurrence rate of high-risk group was 60.1%,65.7%,80.7%,and 83.8%,respectively,whereas,that of low-risk group was 22.7%,40.0%, 53.8%,and 65.4%, respectively. There was a significant difference between the two groups(P=0.00). Conclusion The number of initial colorectal polyps is useful for predicting the risk of polyp recurrence,and the rate of polyp recurrence during surveillance increases with the passage of time. The cumulative recurrence rate of high-risk group after polypectomy is significantly higher than that of low-risk group.
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Objective To investigate the clinical effects of four different bowel preparation methods for colonoscopy.Methods 620 patients examined by coloscopy were randomized into four groups (group A,B,C and D),with each group in 155 cases.Group A received magnesium sulfate.Group B received compound polyethylene glycol.Group C received magnesium sulfate combined with simethicone.Group D received compound polyethylene glycol combined with simethicone.The quality and influencing factors,the detection of polyps and adverse events were compared between the four groups.Results The good bowel cleaning rate of group A,B,C and D were respectively 84.52％,91.61％,85.81％ and 94.19％.The good bowel cleaning rates of group A and C were higher than those of group B and D (x2 =4.32,P ＜ 0.05;x2 =7.63,P ＜ 0.05;x2 =4.10,P ＜ 0.05;x2 =6.06,P ＜ 0.05.).The bubble free rate of group A,B,C and D were 86.45 ％,87.74％,92.26％ and 90.96％.The bubble free rates of group C and D were higher than those of group A and B (x2 =4.17,P ＜ 0.05;x2 =4.76,P ＜ 0.05;x2 =5.02,P ＜ 0.05;x2 =4.23,P ＜ 0.05).The polyp detection rates of group A,B,C and D were 35.4％,36.8％,51.6％ and 54.2％.Group C and D showed higher quality of foam eliminating and detection rate of polyps as compared with group A and B (x2 =8.24,P ＜0.05;x2 =11.04,P ＜0.05;x2 =6.95,P ＜0.05;x2 =9.53,P ＜0.05).The incidence of adverse reactions of group A and C (21.3％ and 19.4％) were higher than group B and D (7.8％ and 6.5％) (x2 =11.86,P＜0.05;x2 =14.95,P ＜0.05;x2 =9.18,P ＜0.05;x2 =11.95,P ＜0.05).The frequency of colonoscopy,constipation,medication and examination time interval,bowel preparation methods and adverse events were the the influ ence factors of bowel preparation.Conclusion The quality of bowel preparation of compound polyethylene glycol electrolyte powder is better than magnesium sulfate with high security.Treatment of combination with simethicone can improve bowel preparation quality.Many factors can affect bowel preparation,which need to be paid attention to.
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Objective To investigate the expression of Epstein-Barr virus(EBV)-latent membrane protein 1 (LMP1) in chronic atrophic gastritis (CAG) with intestinal metaplasia and discuss its effect on gastric cancer.Methods Immunohistochemistry was used to examine the expression of EBV-LMP1 in 45 cases of chronic superficial gastritis(CSG),63 cases of CAG with intestinal metaplasia and 36 cases of gastric cancer.Results There was no expression of EBV-LMP1 in CSG and gastric cancer,while the positive rate of EBV-LMP1 in CAG with intestinal metaplasia was 36.5％ (23/63) and EBV-LMP1 was mainly stained in the cell nucleus.The expression of EBV-LMP1 in CAG with intestinal metaplasia was significantly higher than that in CSG and gastric cancer,and there was significant difference (P =0.000).Conclusions EBV-LMP1 is expressed in CAG with intestinal metaplasia.The expression of EBV-LMP1 is significantly higher than that in CSG and gastric cancer indicating that EBV infection in gastric carcinogenesis may play an important role in the early stages.
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Objective The primary aim of this study was to examine the proportion and natural history of Helicobacter pylori (Hp) negative bleeding peptic ulcers. Methods The study was designed as a multiple-center, case-control study conducted in 14 endoscopy centers in China from April 2006 to March 2007. Each center was expected to recruit 30 peptic ulcer patients with bleeding ( PUB group) and 30 without (PU group). All screened patients with upper gastrointestinal bleeding received endoscopy within 24 hours of admission. Biopsy specimens were taken from the antrum to determine Hp infection by rapid urease test and pathology. Patients with negative Hp infection at first examination were asked to receive urease breathe test (UBT) one month later. Results A total of 617 patients were enrolled with 263 in PUB group and 354 in PU group. There is no significant difference in demographic characters between 2 groups ( P ＞0. 05). The rate of Hp infection in PUB group ( 161/263, 61.2% ) was significantly lower than that in PUgroup (311/354, 87. 9%, P ＜0. 001 ). The incidence of complex ulcer in Hp positive PUB patients was 7.5% ( 12/161 ), which is significantly higher than that in Hp negative PUB patients ( 1/102, 1.0% , P =0. 018). In PUB group, no significant differences were found between Hp positive and negative patients in regarding of age, sex, rates of haematemesis, duodenal ulcer and gastric ulcer, and size of ulcer ( P ＞0. 05 ). Among 102 Hp negative cases in PUB, no positive case was found in UBT one month later. Conclusion We have demonstrated a rise in the incidence of Hp negative bleeding ulcers in China. The idiopathic ulcer was not rare, and might have a higher tendency to cause bleed.
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Objective To investigate the clinical characteristics of postinfectious irritable bowel syndrome (PI-IBS) in Qingdao. Methods Two hundred and four PI-IBS and 2068 non-PI-IBS patients were investigated with questionnaire including general information, symptoms and quality of life scores with microecological study before and after therapy. Results (1) The morbidity rate of PI-IBS in female was 2. times of that in male, which was similar to that in non-PI-IBS. (2) Brainwork labors dominated in both PI-IBS and non-Pl-lBS patients. (3) As to the simultaneous presence of extra-gastrointestinal symptoms,there was no statistical difference between the rate of physical symptoms in PI-IBS and non-PI-IBS patients (X<'2>= 10. 5, P>0.05) ,but the rate of mental symptoms was higher in PI-IBS than in non-PI-IBS patients, and the difference was significant(X<'2>= 28.7, P<0.05). (4)The alteration of intestinal microflora rate in PI-IBS was obviously higher than that in non-PI-IBS patients. (5) The quality of life scores in PI-IBS was improved after treatment with Birid Triple Viable , and there was significant difference(t =3. 8, P<0.01),but there was no statistical difference in non-Pl-IBS (t = 1.5, P>0.05). Conclusion There was some difference in certain clinical characteristics between PI-IBS and non-PI-IBS patients in Qingdao.
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Objective To investigate the effect of infection on the expression of substance P(SP) and Th1 cytokine on colonic mucosa in patients with irritable bowel syndrome(IBS).Methods Mucosa biopsy samples were obtained in descending colon and rectum from 77 patients(20 post-infective-IBS cases)and 30 controls by colonoscopy.The expressions of SP,interleukin(IL)-2,interferon(IFN)-?were determined by immunohistochemical staining.Results Compared with controls,expressions of SP,IL-2 and IFN-?were significantly increased in IBS patients with diarrhea-predominant(P＜0.05),and expression of SP in post-infective-IBS patients with cytokines positive(IL-2 and IFN-?)were also signifi- cantly increased(P＜0.05).There were no significant differences between non post-infective-IBS and controls.Conclusions Expression of SP was significantly increased in post-infective-IBS.SP upregulated the expression of Thl cytokines(IL-2 and IFN-?).Gastrointestinal infection may involve in the patho- genesis of IBS through neuroimmune mechanism.