Cavernous hemangioma of the ileum in a young man: A case report and review of literature.

BACKGROUND: Small intestinal cavernous hemangioma is a rare disease, especially in the ileum. It is difficult to accurately diagnose due to its hidden location and nonspecific clinical symptoms. Here, we reported a case of ileal cavernous hemangioma with chronic hemorrhage in a 20-year-old man and review the literature to gain a better understanding of this disease. CASE SUMMARY: The patient complained of intermittent melena and hematochezia for > 3 mo. The lowest hemoglobin level revealed by laboratory testing was 3.4 g/dL (normal range: 12-16 g/dL). However, the gastroscopy, colonoscopy and peroral double-balloon enteroscopy (DBE) showed no signs of bleeding. The transanal DBE detected a lesion at about 340 cm proximal to the ileocecal valve. Thus, we performed an exploratory laparoscopy and the lesion was resected. After the operation, the patient had no melena. Finally, the pathological examination identified the neoplasm as an ileal cavernous hemangioma, thereby resulting in gastrointestinal hemorrhage. CONCLUSION: This report might improve the diagnosis and treatment of ileal cavernous hemangioma.

Epidemical and etiological study on hand, foot and mouth disease following EV-A71 vaccination in Xiangyang, China.

Coxsackievirus A6 (CV-A6) and Coxsackievirus A10 (CV-A10) have been emerging as the prevailing serotypes and overtaking Enterovirus A71 (EV-A71) and Coxsackievirus A16 (CV-A16) in most areas as main pathogens of hand, foot and mouth disease (HFMD) in China since 2013. To investigate whole etiological spectrum following EV-A71 vaccination of approximate 40,000 infants and young children in Xiangyang, enteroviruses were serotyped in 4415 HFMD cases from October 2016 to December 2017 using Real Time and conventional PCR and cell cultures. Of the typeable 3201 specimen, CV-A6 was the predominant serotype followed by CV-A16, CV-A10, CV-A5, CV-A2 and EV-A71 with proportions of 59.54%, 15.31%, 11.56%, 4.56%, 3.78% and 3.03%, respectively. Other 12 minor serotypes were also detected. The results demonstrated that six major serotypes of enteroviruses were co-circulating, including newly emerged CV-A2 and CV-A5. A dramatic decrease of EV-A71 cases was observed, whereas the total cases remained high. Multivalent vaccines against major serotypes are urgently needed for control of HFMD.

[The relationship of leptin and adiponectin with insulin resistance in nonalcoholic fatty liver disease].

OBJECTIVES: To investigate the serum leptin and adiponectin levels in nonalcoholic fatty liver disease (NAFLD) patients, and their relationship with insulin resistance. METHODS: A total of 120 cases were enrolled and divided into two groups: NAFLD group (n = 60) and normal control group (n = 60). The serum levels of leptin and adiponectin were measured by ELISA. The body mass index (BMI), waist-to-hip ratio (WHR), triglyceride (TG), total cholesterol (Tchol), high-density lipoprotein cholesterol (HDL-C) , aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), fasting blood glucose (FBG) and HOMA-IR (homeostasis model assessment insulin resistance) were detected and analyzed. RESULTS: Compared with control group, the serum leptin level in NAFLD group was Significantly higher [(12.37+/-1.99) microg/L vs (5.20+/-1.03) microg/L, P less than 0.01], while the serum adiponectin level was significantly lower [(12.69+/-2.83) mg/L vs (22.83+/-4.61) mg/L, P less than 0.01]. HOMA-IR was also much higher in NAFLD group than that in control group[(4.86+/-0.63) vs (1.91+/-0.41), P less than 0.01]. Logistic regression analysis showed that leptin was positively correlated with WHR (beta value = 8.175, P less than 0.01), HOMA-IR (beta value = 0.974, P less than 0.01 ), FBG (beta value = 0.564, P less than 0.01 ). In contrast, adiponectin inversely associated with HOMA-IR (beta value = -0.495, P less than 0.01 ) and BMI (beta value = -0.314, P less than 0.01) respectively. CONCLUSION: The increased serum leptin level and decreased serum adiponectin level in NAFLD patients independently associated with HOMA-IR.