The clinical analysis of 34 cases of intestinal tuberculosis in China's big city hospitals.

AIMS: Intestinal tuberculosis is not uncommon in developing countries. The diagnosis of this disease is quite difficult. The purpose of our research was to recall the clinical, colonoscopic, and histopathological features of this disease. METHODS: The clinical, colonoscopic, and histopathological findings were retrospectively analyzed in 34 patients with intestinal colonic tuberculosis in recent 5 years. RESULTS: The mean age of the patients was 34.7 ± 10.5 years. There were 18 males and 16 females in this group. Abdominal pain, fever, diarrhea, weight loss, and fatigue were the commonest symptoms. Extraintestinal tuberculosis was present in 14 patients. Colonoscopy revealed ulcers in 18 patients, nodules in 11, a deformed cecum and ileocecal valve in 17, strictures in five, polypoid lesions in four, and fibrous bands forming mucosal bridges in three. The cecum and ascending colon were the commonest sites involved. Segmental tuberculosis was seen in five of the 34 patients in whom full-length colonoscopy could be performed. Two or more sites were involved in 18 patients. Histopathology revealed well-formed granulomas in 23 patients. Fourteen of the above patients had caseation and 11 had confluence of the granulomas. Ill-formed granulomas were seen in seven patients and chronic inflammatory changes in 13. Both caseation granulomas and stain for acid-fast bacilli in the biopsies positive were from four patients. We divided the patients into groups I (definitive intestinal tuberculosis, 27 cases) and II (suspected intestinal tuberculosis, seven cases). Despite the various histopathological findings, all of the patients responded to antitubercular treatment and continued to remain asymptomatic during the follow-up period. CONCLUSIONS: Colonoscopy with biopsy is essential for diagnosing colonic tuberculosis. Even in the absence of the classic histopathological features, a therapeutic trial may be indicated in a given clinical and colonoscopic setting. Follow-up is important.

Six ulcerative colitis patients with refractory symptoms co-infective with Blastocystis hominis in China.

Blastocystis hominis is an enteric parasite which has long been considered as an innocuous commensal living in the intestinal tract. Our research was to explore the role of B. hominis in refractory ulcerative colitis. Our department admitted 122 cases of ulcerative colitis patients. In these patients, there were 73 cases of patients who were responsive to sulfasalazinec, mesalazine in a standard dosage, according to the symptoms change. There was one patient who was detected to have B. hominis infection through stool detection. There were 49 patients with relapse symptoms. In this group, there were six patients who were detected with B. hominis infection through stool detection. The six patients of refractory ulcerative colitis were treated with metronidazole for 10-14 days. They almost completely recovered 3 weeks later. Patients diagnosed with ulcerative colitis should always consider this parasite infection when the symptoms are refractory and cannot be released.

Zhixue capsule caused seven cases of drug induced hepatitis.

BACKGROUND/AIMS: To report the recently 7 cases of drug induced hepatitis patients in our department. METHODOLOGY: From October 2008 to December 2008, 7 patients were enrolled in our department for drug induced hepatitis caused by Zhixue capsules administration. The Zhixue capsule is composed of cortex dictam and radices sophorae flavescentis. There were 4 female and 3 male patients. The patients were of age 31 to 52 years old. Of those, 6 patients belonged to the hepatocellular injury type and one to the mixed type. The time period Zhixue capsule was administered was from 6 to 18 days. When the patients enrolled into our department, they were treated for jaundice and protective liver function. RESULTS: When the patients were discharged the symptoms were all improved evidently and liver function became normal. One patient with mixed type was hospitalized for 63 days and he was treated with glucocorticoid to help his recovery. CONCLUSIONS: Zhixue capsule could induce acute hepatitis of various types, but mainly hepatocellular injury type. The patients of all types could be recovered with proper treatment. The combined type may need glucocorticoid administration to help recovery.

Endoscopic mucosa resection of a duodenum carcinoid tumor of 1.2 cm diameter: a case report.

Carcinoid tumors of the duodenum are rare, and their natural history has not been defined. Duodenum carcinoid can present with various clinical symptoms. It is difficult to diagnose this disease. When duodenum carcinoid is smaller than 1.0 cm, it can be removed by endoscopy. When it is bigger than 1.0 cm, it should be surgically resected. We report a patient who presented with a duodenum carcinoid 1.2 cm in size. As the patient refused surgical resection, we gave him endoscopic mucosa resection. After one-year follow-up, the duodenum carcinoid was found to be completely resected, and the patient had no cancer metastasis.

Coma caused by isoniazid poisoning in a patient treated with pyridoxine and hemodialysis.

Isoniazid is widely used to treat tuberculosis. In populations with a high prevalence rate of tuberculosis, acute ingestion of isoniazid has been reported as a potential cause of coma. In this study, we present the diagnosis and treatment of isoniazid poisoning in a case with acute coma as the major clinical presentation.A 32-year-old male who ingested 12 g isoniazid (2 hours prior to medical attention) was brought to the emergency department while in a coma and experiencing frequent seizures. Initial treatment with large doses of pyridoxine (for 6 hours) failed to awaken this patient. The patient was then given hemodialysis and pyridoxine; after 3 days he awoke from coma, with no further reported seizures.Isoniazid poisoning should be suspected in patients whose major symptoms are coma and seizure, especially those who have access to isoniazid. Monitoring the blood level of isoniazid will establish the diagnosis and help clinical management. A combination of hemodialysis and pyridoxine is effective in treating isoniazid poisoning.

Hot food and beverage consumption and the risk of esophageal squamous cell carcinoma: A case-control study in a northwest area in China.

BACKGROUND: This study was trying to investigate the association of hot food and beverage consumption and the risk of esophageal squamous cell carcinoma in Hotan, a northwest area of China with high risk of esophageal squmous cell carcinoma. METHODS: A population-based case-control study was designed. For the study, 167 patients diagnosed with esophageal squamous cell carcinoma were selected from Hotan during 2014 to 2015, and 167 community-based controls were selected from the same area, matched with age and sex. Information involved of temperature of food and beverage intake was obtained by face-to-face interview. Logistic regression analyses were performed to investigate the association between temperature of food and beverage intake and the risk of esophageal squamous cell carcinoma. RESULTS: The temperature of the food and beverage consumed by the esophageal squamous cell carcinoma patients was significantly higher than the controls. High temperature of tea, water, and food intake significantly increased the risk of esophageal squamous cell carcinoma by more than 2-fold, with adjusted odds ratio 2.23 (1.45-2.90), 2.13 (1.53-2.66), and 2.98 (1.89-4.12). CONCLUSIONS: Intake of food and beverage with high temperature was positively associated with the incidence of esophageal squamous cell carcinoma in Northwestern China.

A Retrospective Research of the Characteristic of Hypertriglyceridemic Pancreatitis in Beijing, China.

Aim. To investigate the characteristic of hypertriglyceridemic- (HTG-) induced pancreatitis (HTG pancreatitis). Methods. We reviewed 126 cases of HTG pancreatitis and 168 cases of biliary pancreatitis as control. Results. The HTG group mean age was younger than biliary group. The number of females was a little higher than males in both groups. There were 18 cases that were recurrent in HTG group and 11 in billiary group. The mean hospitalization times were 13.7 ± 2.6 and 11.2 ± 2.3 days in two groups. Six patients received apheresis in HTG group. The proportion of severe AP was 31.0% and 26.2%, mortality 1.6% and 1.2%, comorbidity of diabetes mellitus (DM) 20.6% and 6.5% in two groups. The number of complications of gastrointestinal (GI) bleeding, sepsis, and multiple organ dysfunction syndrome (MODS) in HTG group and biliary group was 1, 1, and 2 versus 4, 12, and 4. Conclusions. The proportion of recurrent and severe AP and comorbidity of DM of HTG group was higher than billiary group. The proportion of the complications of GI bleeding, sepsis, and MODS of HTG group was less than biliary group. Apheresis could effectively reduce serum TG levels soon. There was no significant difference of the mortality between two groups.

[The inhibit effect of berberine on human colon cell line cyclooxygenase-2].

OBJECTIVE: To investigate the effect of berberine on human colon cancer cell line HT-29 and the mechanisms of the effects. METHODS: Add 0.1, 0.3, 3.0, 30.0 micro mol/L berberine into the HT-29 cell culture media. The related values were recorded everyday. NS-398 was used as a cyclooxygenase-2 (COX-2) enzyme activity inhibiting agent. The related values included cell growth, test of COX-2 mRNA using RT-PCR method, expression of COX-2 protein with immunocytochemical method, and concentration of prostaglandin E(2) with ELISA method. RESULTS: When the concentration of berberine was higher than 0.3 micro mol/L, there was a significant dose-dependent effect. When the berberine concentration was higher than 0.3 micro mol/L, berberine could inhibit the COX-2 in mRNA and protein level. It could decrease the concentration of prostaglandin E(2) in the culture media. CONCLUSIONS: Berberine can inhibit COX-2 in mRNA and protein level. It can also inhibit the activity of COX-2. This may be one of the mechanisms that berberine inhibit the growth and proliferation of HT-29 human colon cell line.

The inhibition of Wnt/ß-catenin signaling pathway in human colon cancer cells by sulindac.

The aberrant activation of Wnt/ß-catenin signaling plays important roles in the initial development of colon cancer. Sulindac is a commonly used non-steroidal anti-inflammatory drug. We demonstrated the effects of sulindac on growth inhibition, apoptosis induction, and Wnt/ß-catenin signaling suppression in human colon cancer cells. Sulindac significantly inhibited proliferation of HT-29 colon cancer cells in a dose- and time-dependent manner. Sulindac was found to induce the apoptosis of HT-29 cells and inhibit the Wnt/ß-catenin pathway. The inhibition was further confirmed by the decreased protein levels of ß-catenin. The results indicate that sulindac may play a beneficial role in the comprehensive treatment of colon cancer.