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Objective To explore the application value of the modified hypotonic method of intestinal system contrast ultra-sonography in elder patients with small intestinal diseases .Methods Group A were 28 patients with small intestine disease and 8 patients who was found abdominal mass suspected source of intestinal tumors by routine abdominal ultrasound inspection .We con-trast the mannitol intestinal system contrast ultrasound with modified hypotonic method of intestinal system ultrasound contrast , and compare with gastrointestinal ,gastrointestinal barium meal contrast ,then contrast the results of pathology .Group B were 37 patients ,with definite diagnosis with duodenal ulcers ,polyps ,the descending part of the diverticulum ,who respectively treated with drinking water method and modified hypotonic method of intestinal system ultrasound contrast ,then carry the two methods into comparison .Results The nidus detection increase from 9 to 12 in group A ;the nidus detection increase from 13 to 33 in group B . The modified hypotonic method of intestinal system contrast ultrasonography ,which eliminate intestinal gas more obvious and relax the intestinal lumen more sufficient than conventional contrast ,can improve the nidus detection rate .Conclusion The modified hy-potonic method of intestinal system contrast ultrasonography could be as a routine inspection method for elder small intestinal dis-ease paitents .
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Objective To explore the corrective role of lived combined Bacillus subtilis and Enterococcus faecium enteric-coated capsules on the bacteria overgrowth in small intestinal (SIBO)and assess the efficacy and possible mechanism of it in the treatment of diarrhea predominant irritable bowel syndrome (IBS-D).Methods From May to August 2013,IBS-D patients were collected.Screened by lactulose hydrogen breath test (LHBT),and a total of 60 SIBO positive patients were enrolled in the study and divided into experimental group and control group.Live combined Bacillus subtilis and Enterococcus faecium enteric were given to the experimental group and starch given to the control group,both were capsules,each 250 mg,three times per day,two capsules each time,and the treatment course was four weeks.Before and after administration a questionnaire was conducted in the study objects,including basic information (age,gender,disease type,family history and accompanied diseases) and the severe degree of the symptoms (abdominal pain,bloating,abdominal discomfort,increased frequency of defecation,defecation urgency,defecation endless,defecation hard,bowel and exhaust).Fasting peripheral venous blood was taken from the study individuals before and after administration.The level of interleukin (IL)-1β,IL-6,IL-10,IL-12 and tumor necrosis fator-α(TNF-α) in serum were detected by enzyme linked immunosorbent assay(ELISA).t-test was performed for measurement data comparison between two groups,and chi-square test was for count data comparison.Results Among 60 SIBO positive IBS-D patients,30 patients were in experimental group and 30 in control group.The SIBO negative conversion rate of experimental group and control group was 63.3 ％(19/30) and 30.0％ (9/30),the difference was statistically significant (x2 =6.696,P＜0.05).Before and after administration,in control group there were no significant differences in severe degree scoring of abdominal pain,bloating,abdominal discomfort,increased frequency of defecation,defecation urgency,defecation endless,defecation hard,bowel and exhaust or the level of TNF-α,IL-1β,IL-6,IL-10 and IL-12 (all P＞0.05).In experimental group,before and after administration there were statistically significant differences in severe degree scoring of abdominal floating (2.97 ± 1.45 vs 2.61±1.28),level of IL 1β ((1390.81±103.95) ng/L vs (1209.76±113.26) ng/L)and IL-10/IL-12 (4.94±0.74 vs 5.30±0.43),the differences were statistically significant (t=2.052,5.279 and 2.282,all P＜0.05).There were no signinficant differences in other items (all P＞0.05).Conclusions Lived combined Bacillus subtilis and Enterococcus faecium enteric coated capsules could alleviate the symptoms of abdominal floating.The possible mechanism may related with correcting SIBO,inhibiting low degree of inflammation reaction and regulating the inflammatory cytokines.
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Objective To study the diagnostic value of endoscopy assisted by laparoscopy in patients with small intestinal bleeding. Methods In case of small intestinal bleeding it is hard to define the accurate etiological factor by routine examination. From 1994 to 2002 there were 14 patients with chronic me-lena or persisted melena complicated with chronic anemia and 2 cases of acute alimentary tract hematorrhea complicated with obvious hypovolemia. Results Endoscopies assisted by laparoscopy were accomplished in all of the 16 cases. Lesions were detected in 5 cases with laparoscopy directly, and in 11 cases the pathological changes were discovered by endoscopies assisted with laparoscopy . The pathologic results were leiomyo-sarcoma 1 cases, leiomyoma 4 cases, adenoma of small intestine , hemangioma , vascular malformation and capillary telangiectasia 2 cases each, and Meckels diverticulitis with hemorrhage 3 cases. Conclusion The diagnostic value of endoscopy assisted with laparoscopy is superior to the routine examination in detecting the small intestinal bleeding. This technique has the advantage of simple, less-traumatic and high sensitivity. It is worthy to popularize in clinical practice.