Rectal prolapse in a 30-year-old bladder stone male patient: A case report.

BACKGROUND: Rectal prolapse occurs most commonly in children and middle-aged and elderly women and is relatively rare in young men and is occasionally caused by bladder stones. Severe rectal prolapse, bilateral hydronephrosis, and renal insufficiency caused by bladder stones are rare in a 30-year-old man. CASE SUMMARY: We report the case of a 30-year-old male patient with cerebral palsy who presented with a large bladder stone that resulted in severe rectal prolapse, bilateral hydronephrosis, and renal insufficiency. Following a definitive diagnosis, the bladder stone was successfully removed, and his kidney function returned to normal. We assessed the patient's nutritional status and stone composition and concluded that the main cause was malnutrition. CONCLUSION: Rectal prolapse is a rare clinical manifestation of bladder stones, particularly in young adults. Cerebral palsy patients are a vulnerable group in society because of their intellectual disabilities and communicative impairments. Accordingly, besides taking care of their daily diet, abnormal signs in their bodies should receive the doctors' attention in a timely manner.

[Clinical study on combination of multiple regimens in treatment of osteoporosis in perimenopause and postmenopausal women].

OBJECTIVE: To evaluate clinical efficacy of multiple regimen combination in treatment of osteoporosis of perimenopausal or postmenopausal women. METHODS: From Jul. 2008 to Dec. 2009, 109 women with low bone mineral density (BMD) or osteoporosis treated in Department of Obstetrics and Gynecology, Affiliated Second Hospital, Wenzhou Medical College were enrolled randomly into 3 group, including 36 women in Group A managed by osteoform 1000 mg/d + alfacalcidol 0.25 µg/bid orally, 40 women in group B managed by osteoform 1000 mg/d + alfacalcidol 0.25 µg/bid + tibolone 1.25 mg/d orally and 33 women in group C managed by osteoform 1000 mg/d + alfacalcidol 0.25 µg/bid + bisphosphonates 70 mg/w orally. After 48 weeks BMD on lumbar 1-4 (L1₋4) and left femur were detected by X-ray. Bone alkaline phosphatase(BALP), cross linked clelopeptide of type I collagen (CTX) and 25-hydroxychole calciferol [25(OH)D3] was measured by enzyme linked immunosorbent assay (ELISA). RESULT: Seven women (6.4%, 7/109) were withdrawed form this study, including 2 cases losing follow up in group A, 3 cases stopping treatment in group B, 2 cases giving up treatment due to severe adverse effect (burning in upper abdomen) in group C. (1) Pain relieve: after 48 weeks treatment, women in 3 groups improved symptom of pain significantly, the rates of pain relieve were 85% (29/34) in group A, 92% (34/37) in group B and 94% (29/31) in group C. (2) BMD: BMD was improved significantly in women in 3 groups after treatment. BMD of L1₋4 were (0.88 ± 0.15) g/cm² in group A, (0.89 ± 0.18) g/cm² in group B and (0.87 ± 0.10) g/cm² in group C before treatment, and converted to (0.90 ± 0.01) g/cm² in group A, (0.93 ± 0.09) g/cm² in group B and (0.91 ± 0.11) g/cm² in group C after treatment. BMD of left femur were (0.87 ± 0.07) g/cm² in group A, (0.87 ± 0.07) g/cm² in group B and (0.85 ± 0.12) g/cm² in group C before treatment and converted to (0.90 ± 0.03) g/cm² in group A, (0.91 ± 0.08) g/cm² in group B and (0.89 ± 0.12) g/cm² in group C after treatment. It was shown significantly different BMD between group B or C and group A (P < 0.01), however, there was no significant different BMD between group B and C (P > 0.05). (3) Index of bone metabolism: BALP were (26 ± 6) µg/L in group A, (26 ± 9) µg/L in group B and (28 ± 7) µg/L in group C before treatment and converted to (22 ± 5) µg/L in group A, (20 ± 9) µg/L in group B and (22 ± 8) µg/L in group C after treatment, which showed statistical difference (P < 0.05). CTX were (0.85 ± 0.20) ng/L in group A, (0.84 ± 0.47) ng/L in group B, and (0.88 ± 0.11) ng/L in group C before treatment and converted to (0.81 ± 0.19) ng/L in group A, (0.77 ± 0.33) ng/L in group B, and (0.82 ± 0.14) ng/L in group C after treatment, which showed statistical difference (P < 0.05). CONCLUSIONS: Those 3 regimens combination could be used in treatment of osteoporosis by decreasing bone conversion, increasing bone density, decreasing bone absorption. Regimen A was only suitable for basic therapy, the other two regimens could provide better treatment.

[Analysis of single nucleotide polymorphism in the human beta-globin gene of patients with minor beta-thalassemia from Wenzhou].

This study was aimed to analyze the hematologic and molecular biologic characteristics of 14 Wenzhou patients with minor beta-thalassemia, to find out the mutation sites responsible for the disease by detecting sequences of PCR products and to analyze the single nucleotide polymorphism. The peripheral blood of patients was collected intravenously and was anticoagulated with EDTA-K(2); then the templates from blood samples were extracted, the related primers were designed for sequencing the products amplified by PCR; finally mutation sites resulting in beta-thalassemia were found through comparison and analysis of sequences. The results indicated that the C-->T heterozygous mutation occurred at the IVS-2 -654 site in 4 cases; the TTCT deficiency appeared at CD41/42 site in 1 case; in 2 sites existed single nucleotide polymorphisms occurring at the 59th site of exon 1 (T/C, CAT/CAC, His) and IVS-2 nt 665 (T/C). It is concluded that single nucleotide polymorphism of minor beta-thalassemia patients born in Wenzhou had specificity, this study found too kinds of gene mutations which are IVS-2 -654 C-->T heterozygous mutation and CD41/CD42 site-TTCT deficiency.