BACKGROUND Congenital intestinal atresia(CIA)is a common intestinal malformation in the neonatal period,and surgery is currently the main treatment method.The choice of postoperative feeding is crucial for the recover...BACKGROUND Congenital intestinal atresia(CIA)is a common intestinal malformation in the neonatal period,and surgery is currently the main treatment method.The choice of postoperative feeding is crucial for the recovery of gastrointestinal function in children.AIM To compare and analyze the effects of different postoperative feeding methods on gastrointestinal function reconstruction in newborns with CIA.METHODS Twenty-six children diagnosed with neonatal CIA,treated with minimally invasive surgery at Shijiazhuang Maternal and Child Health Hospital between January 2021 and May 2024,were selected for this single-center prospective randomized controlled study.They were divided into two groups using envelope randomization:Enteral nutrition(EN)group(n=13)and parenteral nutrition(PN)group(n=13).Baseline and clinical characteristics were collected,and recovery time of bowel sounds and time to first defecation were used as evaluation indices for gastrointestinal functional reconstruction.Differences between the groups were analyzed using t-test,χ2 test,and Fisher’s exact test.Spearman’s correlation tests and linear regression models were employed to analyze factors influencing time to first defecation.RESULTS The time to bowel sound recovery(51.54 vs 65.85,P=0.013)and first defecation(58.15 vs 76.62,P<0.001)was shorter in the EN group compared to the PN group.Clinical improvements in the EN group,including discharge weight(P=0.044),hospital stay(P=0.027),white blood cell count(P=0.023),albumin content(P=0.013),and direct bilirubin content(P=0.018),were also better than those in the PN group.No substantial differences in postoperative complications were found between the groups.Correlation analysis indicated that abdominal infection and operation time may relate to time to first defecation.Linear regression analysis demonstrated a considerable association between EN feeding and shorter time to first defecation.Abdominal infection and an operation time>2 hours may be risk factors for prolonged time to first defecation.CONCLUSION EN substantially promotes the recovery of gastrointestinal function after CIA in neonates and can improve clinical outcomes in children.Future research should explore optimal EN practices to enhance clinical application and child health.展开更多
Background: Lysine is used widely in livestock production due to the shortage of feed protein resources.Llysine·H2SO4 contains L-lysine sulphate as well as fermentation co-products which contain other amino acids...Background: Lysine is used widely in livestock production due to the shortage of feed protein resources.Llysine·H2SO4 contains L-lysine sulphate as well as fermentation co-products which contain other amino acids and phosphorus.However,there are few articles about L-lysine·H2SO4 product regarding intestinal morphology and liver pathology of broiler chickens.In this article,we focus on the absorption and metabolism of L-lysine·H2SO4 revealed in the variation of intestinal morphology and liver pathology to determine the tolerance of chicks for L-lysine·H2SO4.Methods: To evaluate the tolerance of broilers for L-lysine·H2SO4,240 one day old broilers were allocated randomly to one of five dietary treatments which included corn-soybean diets containing 0,1%,4%,7% or 10% L-lysine·H2SO4(L-lysine content = 55%).Results: Supplementation of 1% L-lysine·H2SO4 in the diet had no negative effects.However,4%,7% or 10% Llysine·H2SO4 supplementation produced negative responses on broiler performance,carcass characteristics,blood biochemistry,and particularly on intestinal morphology and liver pathology compared with broilers fed the control diet.Conclusion: Our results show that supplementation with 1% L-lysine·H2SO4 had no negative effects on performance,carcass characteristics,blood biochemistry,intestinal morphology and liver pathology in broilers,but supplementation with 4%,7% or 10% L-lysine·H2SO4 produced a negative response,particularly with respect to intestinal morphology and liver pathology.展开更多
Coccidiosis is a disease caused by intracellular protozoan parasites, specifically belonging to the genus Eimeria. These parasites target the gastrointestinal tract in different types of hosts, causing sores in the in...Coccidiosis is a disease caused by intracellular protozoan parasites, specifically belonging to the genus Eimeria. These parasites target the gastrointestinal tract in different types of hosts, causing sores in the intestinal lining. The presence of these lesions reduces the animal’s ability to digest and absorb nutrients, significantly impacting their overall performance. The current study aimed to explore the potential correlation between seasonal variations and the incidence of Eimeria spp-induced lesions in broiler chickens’ gastrointestinal tracts in Brazil from 2012 to 2018. A total of 8,607 broiler chickens, aged 14 to 42 days, were sampled from 103 poultry integrated companies in Brazil to conduct intestinal health examinations. The sampling process involved selecting 3 to 6 chickens from each poultry house for examination. The assessment included various abnormalities such as shedding of intestinal cells and excessive fluid and mucus presence, thickening and tension of the intestines, food movement, roughened mucosal surface resembling a Turkish towel in the small intestine, tissue death, duodenal inflammation, intestinal inflammation, gizzard erosion, presence of worms and bedding material, and ingestion of mealworms. During the seasons, winter exhibited the highest average occurrence of Eimeria maxima microorganisms at 52.83%, with E. acervulina following closely at 26.42% in second place. In spring, E. maxima had an occurrence of 11.31%, while in fall, E. tenella had the lowest occurrence at 6.74%. When analyzing the seasonal occurrence of Eimeria, it was observed that E. maxima micro was more common during winter compared to summer (P = 0.0491). However, no discernible variation was observed in the occurrence of the remaining species across different seasons. Research findings suggest that subclinical coccidiosis is most prevalent during the winter season in Brazil. Likewise, clinical disease caused by E. acervulina is also prevalent during this time. In contrast, E. maxima is more likely to cause clinical disease in the spring, whereas E. tenella is more commonly associated with clinical disease in the fall. Lesions induced by Eimeria spp. are associated with factors influencing the overall health of broiler intestines. These findings allow for the utilization of seasonal metrics in disease management, thereby reducing economic losses associated with the condition.展开更多
The objective of this study was to investigate the effects of agar oligosaccharide-iron(AOS-iron)on intestinal tissue pathology and microbiota in IDA rats induced by a low-iron diet,further to find the relationship be...The objective of this study was to investigate the effects of agar oligosaccharide-iron(AOS-iron)on intestinal tissue pathology and microbiota in IDA rats induced by a low-iron diet,further to find the relationship between intestinal microbiota and iron metabolic disorders.After 4 weeks of AOS-iron supplementation,the fecal iron content of IDA rats markedly increased in a dose-dependent manner,only the damaged cecum and colon tissues in medium-dose(MD)and high-dose(HD)groups were repaired to the baseline,while the diversity of gut microbiota was improved even at low dose(LD).Furthermore,the supplementation of AOS-iron altered the composition of gut microbiota.At the genus level,the beneficial microbiota was enriched in AOS-iron groups,but the relative abundance of potential opportunistic pathogens obviously reduced compared to that in the anemia model(AM)group.Spearman’s correlation analysis revealed that biochemical parameters,including blood metabolic parameters,iron contents,body weight,GSH-PX and T-AOC activity,were positively correlated with SMB53,Anaerotruncus,Anaerostipes and Coprobacillus but negatively correlated with Morganella,Fusobacterium and Serratia.These findings indicated that AOS-iron effectively repaired the damaged intestinal tissue and ameliorated iron metabolic disorders by regulating gut microbiota desirably,which could provide references for the treatment of IDA.展开更多
BACKGROUND The appearance of the intestinal mucosa during endoscopy varies among patients with primary intestinal lymphangiectasia(PIL).AIM To classify the endoscopic features of the intestinal mucosa in PIL under end...BACKGROUND The appearance of the intestinal mucosa during endoscopy varies among patients with primary intestinal lymphangiectasia(PIL).AIM To classify the endoscopic features of the intestinal mucosa in PIL under endoscopy,combine the patients’imaging and pathological characteristics of the patients,and explain their causes.METHODS We retrospectively analyzed the endoscopic images of 123 patients with PIL who were treated at the hospital between January 1,2007 and December 31,2018.We compared and analyzed all endoscopic images,classified them into four types according to the endoscopic features of the intestinal mucosa,and analyzed the post-lymphographic computed tomography(PLCT)and pathological characteristics of each type.RESULTS According to the endoscopic features of PIL in 123 patients observed during endoscopy,they were classified into four types:nodular-type,granular-type,vesicular-type,and edematous-type.PLCT showed diffuse thickening of the small intestinal wall,and no contrast agent was seen in the small intestinal wall and mesentery in the patients with nodular and granular types.Contrast agent was scattered in the small intestinal wall and mesentery in the patients with vesicular and edematous types.Analysis of the small intestinal mucosal pathology revealed that nodular-type and granulartype lymphangiectasia involved the small intestine mucosa in four layers,whereas ectasia of the vesicular-and edematous-type lymphatic vessels largely involved the lamina propria mucosae,submucosae,and muscular layers.CONCLUSION Endoscopic classification,combined with the patients’clinical manifestations and pathological examination results,is significant and very useful to clinicians when scoping patients with suspected PIL.展开更多
Introduction: Pneumatosis cystoides intestinalis is a rare condition characterized by the presence of gas cysts in the intestinal wall. It can affect different segments of the digestive tract. Male patients over 50 ye...Introduction: Pneumatosis cystoides intestinalis is a rare condition characterized by the presence of gas cysts in the intestinal wall. It can affect different segments of the digestive tract. Male patients over 50 years old seem to be more affected. Classically, one opposes the primary or idiopathic forms and the secondary forms. Case Report: We report the case of a 62-year-old female patient with a history of treated peptic ulcers, who presented with episodes of intermittent atypical abdominal pain that worsened abruptly. The physical examination revealed a surgical abdomen with tenderness to palpation. The patient underwent a jejunal resection. The pathological examination showed macroscopically an intestinal fragment with confluent subserosal and intestinal intraparietal bullae. On opening, the portion containing the bullae was thickened, infarcted, congestive, hemorrhagic, and brittle with narrowing of the intestinal lumen. The bullae are tense and leave serosities. On histological examination, the intestinal wall was very congestive with hemorrhagic patches of suffusion. There were optically empty cystic formations that do not communicate with the digestive lumen. The adjacent mucosa is the site of a moderate subacute inflammatory reaction. Conclusion: Pneumatosis cystoides intestinalis is a rare and usually benign pathology. The symptoms, when they exist, are not specific. Its physiopathology is still very much debated. The prognosis is generally good. The knowledge of this pathology is necessary to avoid invasive explorations and heavy treatment without interest for the patient.展开更多
BACKGROUND Angiosarcoma is a highly malignant soft-tissue sarcoma derived from vascular endothelial cells that mainly occurs in the skin and subcutaneous tissues.Smallintestinal angiosarcomas are rare,and the prognosi...BACKGROUND Angiosarcoma is a highly malignant soft-tissue sarcoma derived from vascular endothelial cells that mainly occurs in the skin and subcutaneous tissues.Smallintestinal angiosarcomas are rare,and the prognosis is poor.CASE SUMMARY We reported a case of primary multifocal ileal angiosarcoma and analyze previously reported cases to improve our understanding of small intestinal angiosarcoma.Small intestinal angiosarcoma is more common in elderly and male patients.Gastrointestinal bleeding,anemia,abdominal pain,weakness,and weight loss were the common symptoms.CD31,CD34,factor VIII-related antigen,ETS-related gene,friend leukemia integration 1,and von Willebrand factor are valuable immunohistochemical markers for the diagnosis of small-intestinal angiosarcoma.Small-intestinal angiosarcoma most commonly occurs in the jejunum,followed by the ileum and duodenum.Radiation and toxicant exposure are risk factors for angiosarcoma.After a definite diagnosis,the mean and median survival time was 8 mo and 3 mo,respectively.Kaplan-Meier survival analysis showed that age,infiltration depth,chemotherapy,and the number of small intestinal segments invaded by tumor lesions were prognostic factors for small intestinal angiosarcoma.Multivariate Cox regression analysis showed that chemotherapy and surgery significantly improved patient prognosis.CONCLUSION Angiosarcoma should be considered for unexplained melena and abdominal pain,especially in older men and patients with a history of radiation exposure.Prompt treatment,including surgery and adjuvant chemotherapy,is essential to prolonging patient survival.展开更多
Background： Human Cytomegalovirus（HCMV） infections can be found throughout the body, especially in epithelial tissue. Animal model was established by inoculation of HCMV（strain AD-169） or coinoculation with Hepat...Background： Human Cytomegalovirus（HCMV） infections can be found throughout the body, especially in epithelial tissue. Animal model was established by inoculation of HCMV（strain AD-169） or coinoculation with Hepatitis E virus（HEV） into the ligated sacculus rotundus and vermiform appendix in living rabbits. The specimens were collected from animals sacrificed 1 and a half hours after infection.Results： The virus was found to be capable of reproducing in these specimens through RT-PCR and Western-blot.Severe inflammation damage was found in HCMV-infected tissue. The viral protein could be detected in high amounts in the mucosal epithelium and lamina propria by immunohistochemistry and immunofluorescense.Moreover, there are strong positive signals in lymphocytes, macrophages, and lymphoid follicles. Quantitative statistics indicate that lymphocytes among epithlium cells increased significantly in viral infection groups.Conclusions： The results showed that HCMV or HEV ＋ HCMV can efficiently infect in rabbits by vivo ligated intestine loop inoculation. The present study successfully developed an infective model in vivo rabbit ligated intestinal Loop for HCMV pathogenesis study. This rabbit model can be helpful for understanding modulation of the gut immune system with HCMV infection.展开更多
BACKGROUND Esophageal replacement(ER)with gastric pull-up(GPU)or jejunal interposition(JI)used to be the standard treatment for long-gap esophageal atresia(LGEA).Changes of the ER grafts on a macro-and microscopic lev...BACKGROUND Esophageal replacement(ER)with gastric pull-up(GPU)or jejunal interposition(JI)used to be the standard treatment for long-gap esophageal atresia(LGEA).Changes of the ER grafts on a macro-and microscopic level however,are unknown.AIM To evaluate long-term clinical symptoms and anatomical and mucosal changes in adolescents and adults after ER for LGEA.METHODS A cohort study was conducted including all LGEA patients≥16 years who had undergone GPU or JI between 1985-2003 at two tertiary referral centers in the Netherlands.Patients underwent clinical assessment,contrast study and endoscopy with biopsy.Data was collected prospectively.Group differences between JI and GPU patients,and associations between different outcome measures were assessed using the Fisher’s exact test for bivariate variables and the Mann-Whitney U-test for continuous variables.Differences with a P-value<0.05 were considered statistically significant.RESULTS Nine GPU patients and eleven JI patients were included.Median age at follow-up was 21.5 years and 24.4 years,respectively.Reflux was reported in six GPU patients(67%)vs four JI patients(36%)(P=0.37).Dysphagia symptoms were reported in 64%of JI patients,compared to 22%of GPU patients(P=0.09).Contrast studies showed dilatation of the jejunal graft in six patients(55%)and graft lengthening in four of these six patients.Endoscopy revealed columnar-lined esophagus in three GPU patients(33%)and intestinal metaplasia was histologically confirmed in two patients(22%).No association was found between reflux symptoms and macroscopic anomalies or intestinal metaplasia.Three GPU patients(33%)experienced severe feeding problems vs none in the JI group.The median body mass index of JI patients was 20.9 kg/m^(2) vs 19.5 kg/m^(2) in GPU patients(P=0.08).CONCLUSION The majority of GPU patients had reflux and intestinal metaplasia in 22%.The majority of JI patients had dysphagia and a dilated graft.Follow-up after ER for LGEA is essential.展开更多
文摘BACKGROUND Congenital intestinal atresia(CIA)is a common intestinal malformation in the neonatal period,and surgery is currently the main treatment method.The choice of postoperative feeding is crucial for the recovery of gastrointestinal function in children.AIM To compare and analyze the effects of different postoperative feeding methods on gastrointestinal function reconstruction in newborns with CIA.METHODS Twenty-six children diagnosed with neonatal CIA,treated with minimally invasive surgery at Shijiazhuang Maternal and Child Health Hospital between January 2021 and May 2024,were selected for this single-center prospective randomized controlled study.They were divided into two groups using envelope randomization:Enteral nutrition(EN)group(n=13)and parenteral nutrition(PN)group(n=13).Baseline and clinical characteristics were collected,and recovery time of bowel sounds and time to first defecation were used as evaluation indices for gastrointestinal functional reconstruction.Differences between the groups were analyzed using t-test,χ2 test,and Fisher’s exact test.Spearman’s correlation tests and linear regression models were employed to analyze factors influencing time to first defecation.RESULTS The time to bowel sound recovery(51.54 vs 65.85,P=0.013)and first defecation(58.15 vs 76.62,P<0.001)was shorter in the EN group compared to the PN group.Clinical improvements in the EN group,including discharge weight(P=0.044),hospital stay(P=0.027),white blood cell count(P=0.023),albumin content(P=0.013),and direct bilirubin content(P=0.018),were also better than those in the PN group.No substantial differences in postoperative complications were found between the groups.Correlation analysis indicated that abdominal infection and operation time may relate to time to first defecation.Linear regression analysis demonstrated a considerable association between EN feeding and shorter time to first defecation.Abdominal infection and an operation time>2 hours may be risk factors for prolonged time to first defecation.CONCLUSION EN substantially promotes the recovery of gastrointestinal function after CIA in neonates and can improve clinical outcomes in children.Future research should explore optimal EN practices to enhance clinical application and child health.
基金The present study was supported by the 111 Project(B16044)of China
文摘Background: Lysine is used widely in livestock production due to the shortage of feed protein resources.Llysine·H2SO4 contains L-lysine sulphate as well as fermentation co-products which contain other amino acids and phosphorus.However,there are few articles about L-lysine·H2SO4 product regarding intestinal morphology and liver pathology of broiler chickens.In this article,we focus on the absorption and metabolism of L-lysine·H2SO4 revealed in the variation of intestinal morphology and liver pathology to determine the tolerance of chicks for L-lysine·H2SO4.Methods: To evaluate the tolerance of broilers for L-lysine·H2SO4,240 one day old broilers were allocated randomly to one of five dietary treatments which included corn-soybean diets containing 0,1%,4%,7% or 10% L-lysine·H2SO4(L-lysine content = 55%).Results: Supplementation of 1% L-lysine·H2SO4 in the diet had no negative effects.However,4%,7% or 10% Llysine·H2SO4 supplementation produced negative responses on broiler performance,carcass characteristics,blood biochemistry,and particularly on intestinal morphology and liver pathology compared with broilers fed the control diet.Conclusion: Our results show that supplementation with 1% L-lysine·H2SO4 had no negative effects on performance,carcass characteristics,blood biochemistry,intestinal morphology and liver pathology in broilers,but supplementation with 4%,7% or 10% L-lysine·H2SO4 produced a negative response,particularly with respect to intestinal morphology and liver pathology.
文摘Coccidiosis is a disease caused by intracellular protozoan parasites, specifically belonging to the genus Eimeria. These parasites target the gastrointestinal tract in different types of hosts, causing sores in the intestinal lining. The presence of these lesions reduces the animal’s ability to digest and absorb nutrients, significantly impacting their overall performance. The current study aimed to explore the potential correlation between seasonal variations and the incidence of Eimeria spp-induced lesions in broiler chickens’ gastrointestinal tracts in Brazil from 2012 to 2018. A total of 8,607 broiler chickens, aged 14 to 42 days, were sampled from 103 poultry integrated companies in Brazil to conduct intestinal health examinations. The sampling process involved selecting 3 to 6 chickens from each poultry house for examination. The assessment included various abnormalities such as shedding of intestinal cells and excessive fluid and mucus presence, thickening and tension of the intestines, food movement, roughened mucosal surface resembling a Turkish towel in the small intestine, tissue death, duodenal inflammation, intestinal inflammation, gizzard erosion, presence of worms and bedding material, and ingestion of mealworms. During the seasons, winter exhibited the highest average occurrence of Eimeria maxima microorganisms at 52.83%, with E. acervulina following closely at 26.42% in second place. In spring, E. maxima had an occurrence of 11.31%, while in fall, E. tenella had the lowest occurrence at 6.74%. When analyzing the seasonal occurrence of Eimeria, it was observed that E. maxima micro was more common during winter compared to summer (P = 0.0491). However, no discernible variation was observed in the occurrence of the remaining species across different seasons. Research findings suggest that subclinical coccidiosis is most prevalent during the winter season in Brazil. Likewise, clinical disease caused by E. acervulina is also prevalent during this time. In contrast, E. maxima is more likely to cause clinical disease in the spring, whereas E. tenella is more commonly associated with clinical disease in the fall. Lesions induced by Eimeria spp. are associated with factors influencing the overall health of broiler intestines. These findings allow for the utilization of seasonal metrics in disease management, thereby reducing economic losses associated with the condition.
基金the General Program of the National Natural Science Foundation of China(No.31271913)Fujian Regional Development Project(2016N3004)Scientific and Technological Innovation Fund of Fujian Agriculture and Forestry University(No.CXZX2018059).
文摘The objective of this study was to investigate the effects of agar oligosaccharide-iron(AOS-iron)on intestinal tissue pathology and microbiota in IDA rats induced by a low-iron diet,further to find the relationship between intestinal microbiota and iron metabolic disorders.After 4 weeks of AOS-iron supplementation,the fecal iron content of IDA rats markedly increased in a dose-dependent manner,only the damaged cecum and colon tissues in medium-dose(MD)and high-dose(HD)groups were repaired to the baseline,while the diversity of gut microbiota was improved even at low dose(LD).Furthermore,the supplementation of AOS-iron altered the composition of gut microbiota.At the genus level,the beneficial microbiota was enriched in AOS-iron groups,but the relative abundance of potential opportunistic pathogens obviously reduced compared to that in the anemia model(AM)group.Spearman’s correlation analysis revealed that biochemical parameters,including blood metabolic parameters,iron contents,body weight,GSH-PX and T-AOC activity,were positively correlated with SMB53,Anaerotruncus,Anaerostipes and Coprobacillus but negatively correlated with Morganella,Fusobacterium and Serratia.These findings indicated that AOS-iron effectively repaired the damaged intestinal tissue and ameliorated iron metabolic disorders by regulating gut microbiota desirably,which could provide references for the treatment of IDA.
基金Supported by National Natural Science Foundation of China,No.61876216Beijing Shijitan Hospital Foundation of Capital Medical University,No.2019-LB12.
文摘BACKGROUND The appearance of the intestinal mucosa during endoscopy varies among patients with primary intestinal lymphangiectasia(PIL).AIM To classify the endoscopic features of the intestinal mucosa in PIL under endoscopy,combine the patients’imaging and pathological characteristics of the patients,and explain their causes.METHODS We retrospectively analyzed the endoscopic images of 123 patients with PIL who were treated at the hospital between January 1,2007 and December 31,2018.We compared and analyzed all endoscopic images,classified them into four types according to the endoscopic features of the intestinal mucosa,and analyzed the post-lymphographic computed tomography(PLCT)and pathological characteristics of each type.RESULTS According to the endoscopic features of PIL in 123 patients observed during endoscopy,they were classified into four types:nodular-type,granular-type,vesicular-type,and edematous-type.PLCT showed diffuse thickening of the small intestinal wall,and no contrast agent was seen in the small intestinal wall and mesentery in the patients with nodular and granular types.Contrast agent was scattered in the small intestinal wall and mesentery in the patients with vesicular and edematous types.Analysis of the small intestinal mucosal pathology revealed that nodular-type and granulartype lymphangiectasia involved the small intestine mucosa in four layers,whereas ectasia of the vesicular-and edematous-type lymphatic vessels largely involved the lamina propria mucosae,submucosae,and muscular layers.CONCLUSION Endoscopic classification,combined with the patients’clinical manifestations and pathological examination results,is significant and very useful to clinicians when scoping patients with suspected PIL.
文摘Introduction: Pneumatosis cystoides intestinalis is a rare condition characterized by the presence of gas cysts in the intestinal wall. It can affect different segments of the digestive tract. Male patients over 50 years old seem to be more affected. Classically, one opposes the primary or idiopathic forms and the secondary forms. Case Report: We report the case of a 62-year-old female patient with a history of treated peptic ulcers, who presented with episodes of intermittent atypical abdominal pain that worsened abruptly. The physical examination revealed a surgical abdomen with tenderness to palpation. The patient underwent a jejunal resection. The pathological examination showed macroscopically an intestinal fragment with confluent subserosal and intestinal intraparietal bullae. On opening, the portion containing the bullae was thickened, infarcted, congestive, hemorrhagic, and brittle with narrowing of the intestinal lumen. The bullae are tense and leave serosities. On histological examination, the intestinal wall was very congestive with hemorrhagic patches of suffusion. There were optically empty cystic formations that do not communicate with the digestive lumen. The adjacent mucosa is the site of a moderate subacute inflammatory reaction. Conclusion: Pneumatosis cystoides intestinalis is a rare and usually benign pathology. The symptoms, when they exist, are not specific. Its physiopathology is still very much debated. The prognosis is generally good. The knowledge of this pathology is necessary to avoid invasive explorations and heavy treatment without interest for the patient.
文摘BACKGROUND Angiosarcoma is a highly malignant soft-tissue sarcoma derived from vascular endothelial cells that mainly occurs in the skin and subcutaneous tissues.Smallintestinal angiosarcomas are rare,and the prognosis is poor.CASE SUMMARY We reported a case of primary multifocal ileal angiosarcoma and analyze previously reported cases to improve our understanding of small intestinal angiosarcoma.Small intestinal angiosarcoma is more common in elderly and male patients.Gastrointestinal bleeding,anemia,abdominal pain,weakness,and weight loss were the common symptoms.CD31,CD34,factor VIII-related antigen,ETS-related gene,friend leukemia integration 1,and von Willebrand factor are valuable immunohistochemical markers for the diagnosis of small-intestinal angiosarcoma.Small-intestinal angiosarcoma most commonly occurs in the jejunum,followed by the ileum and duodenum.Radiation and toxicant exposure are risk factors for angiosarcoma.After a definite diagnosis,the mean and median survival time was 8 mo and 3 mo,respectively.Kaplan-Meier survival analysis showed that age,infiltration depth,chemotherapy,and the number of small intestinal segments invaded by tumor lesions were prognostic factors for small intestinal angiosarcoma.Multivariate Cox regression analysis showed that chemotherapy and surgery significantly improved patient prognosis.CONCLUSION Angiosarcoma should be considered for unexplained melena and abdominal pain,especially in older men and patients with a history of radiation exposure.Prompt treatment,including surgery and adjuvant chemotherapy,is essential to prolonging patient survival.
基金supported by the National Natural Science Foundation of China(31272515,31472165,31330076)
文摘Background： Human Cytomegalovirus（HCMV） infections can be found throughout the body, especially in epithelial tissue. Animal model was established by inoculation of HCMV（strain AD-169） or coinoculation with Hepatitis E virus（HEV） into the ligated sacculus rotundus and vermiform appendix in living rabbits. The specimens were collected from animals sacrificed 1 and a half hours after infection.Results： The virus was found to be capable of reproducing in these specimens through RT-PCR and Western-blot.Severe inflammation damage was found in HCMV-infected tissue. The viral protein could be detected in high amounts in the mucosal epithelium and lamina propria by immunohistochemistry and immunofluorescense.Moreover, there are strong positive signals in lymphocytes, macrophages, and lymphoid follicles. Quantitative statistics indicate that lymphocytes among epithlium cells increased significantly in viral infection groups.Conclusions： The results showed that HCMV or HEV ＋ HCMV can efficiently infect in rabbits by vivo ligated intestine loop inoculation. The present study successfully developed an infective model in vivo rabbit ligated intestinal Loop for HCMV pathogenesis study. This rabbit model can be helpful for understanding modulation of the gut immune system with HCMV infection.
文摘BACKGROUND Esophageal replacement(ER)with gastric pull-up(GPU)or jejunal interposition(JI)used to be the standard treatment for long-gap esophageal atresia(LGEA).Changes of the ER grafts on a macro-and microscopic level however,are unknown.AIM To evaluate long-term clinical symptoms and anatomical and mucosal changes in adolescents and adults after ER for LGEA.METHODS A cohort study was conducted including all LGEA patients≥16 years who had undergone GPU or JI between 1985-2003 at two tertiary referral centers in the Netherlands.Patients underwent clinical assessment,contrast study and endoscopy with biopsy.Data was collected prospectively.Group differences between JI and GPU patients,and associations between different outcome measures were assessed using the Fisher’s exact test for bivariate variables and the Mann-Whitney U-test for continuous variables.Differences with a P-value<0.05 were considered statistically significant.RESULTS Nine GPU patients and eleven JI patients were included.Median age at follow-up was 21.5 years and 24.4 years,respectively.Reflux was reported in six GPU patients(67%)vs four JI patients(36%)(P=0.37).Dysphagia symptoms were reported in 64%of JI patients,compared to 22%of GPU patients(P=0.09).Contrast studies showed dilatation of the jejunal graft in six patients(55%)and graft lengthening in four of these six patients.Endoscopy revealed columnar-lined esophagus in three GPU patients(33%)and intestinal metaplasia was histologically confirmed in two patients(22%).No association was found between reflux symptoms and macroscopic anomalies or intestinal metaplasia.Three GPU patients(33%)experienced severe feeding problems vs none in the JI group.The median body mass index of JI patients was 20.9 kg/m^(2) vs 19.5 kg/m^(2) in GPU patients(P=0.08).CONCLUSION The majority of GPU patients had reflux and intestinal metaplasia in 22%.The majority of JI patients had dysphagia and a dilated graft.Follow-up after ER for LGEA is essential.
