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Objective To investigate the value of a diagnostic criterion of capsule endoscopy (CE)for small bowel Crohn's disease (CD). Methods The clinical data of 50 patients with suspected CD who underwent CE from March 2003 to October 2008 were analyzed retrospectively. Diagnoses were made based on a criterion proposed by De Bona et al. Patients were grouped and followed up for 1 to 5 years. Results A total of 50 patients were enrolled and divided into 3 groups according to the results of CE. Group A included 25 patients as having small intestine CD on CE, in which 3 received surgery and was confirmed by pathology, and the other 22 got improved after treatments for CD. Group B was comprised of 15 patients who were clinically diagnosed as small intestinal CD and received experimental treatments, in which 13 patients improved and 2 others received surgery and were confirmed to be small intestine diverticula. Patients in group C ( n = 10) were diagnosed as non-specific enteritis and received medication of Bifico and metronidazole for at least 3 months. All patients were followed up for 1 to 5 years and no recurrence was observed. Conclusion This diagnostic criterion of CE for small bowel CD enables early diagnosis of the disease.
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Objective To investigate the safety and efficacy of autologous haematopoietic stem cell transplantation (HSCT) in treatment of patients with refractory inflammatory bowel disease (IBD). Methods Ten patients with active moderate-severe IBD [nine with Crohn's disease (CD) and one with ulcerative disease (UC)] were treated with HSCT from January 2004 to August 2006.Among 9 CD patients,the CD active inedx(CDAl) of 2 patients were above 450 (severe),6 patients were 150-450 (active).One patient was suffered from severe UC(whole colon).The stem cells were collected from the patients who intravenously received cycloptlosphamide (2.0 g/m2 ) and granulocyte colony-stimulating factor (5 μg · kg-1 · d-1 ).The CD34+ cells were isolated and cryo-preserved.After 2 weeks,the HSCT was carried out.Results In 9 patients with CD,clinical complete remission (CDAI<150) was achieved in 5 and 1 patients at 3 and 12 months after HSCT.The CDAI of other 2 patients decreased but not reached clinical complete remission.The patients were followed up of 16.1 months (ranged 10-33 months).The disease relapsed in 4 patients and complete remission in 5 patients.However,no improvement was observed under repeated eolonoscopy in 1 patient with UC who had not relapsed in 10 months.HSCT-related side effects included neutropenia caused fever,infection,etc.One HBV-carrier developed asymptomatie increase of liver enzymes and HBV-DNA copies after HSCT.Conclusions Autologous HSCT can be conducted safely and is well tolerated in patients with refractory IBD.It can induce clinical remission in most of the patients,although endoscopic remission may not be achieved,and relapses can not be avoided in some patients.
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Objective:To identify the role of NO changes in L-arginine induced model of acute pancreatitis in rats. Methods: Acute pancreatitis was induced with a single intraperitoneal injection of 500 mg/100 g body weight of L-arginine. The contents of NO were measured at 6 h,12 h,24 h,48 h,72 h after injection. Results: The content changes of NO in the pancreatic tissues of the rats were decreasing with pancreatitis exacerbating and reaching the lowest value in 48 h when the severity of pancreatic necrosis became serious, then began to rise slowly. The controls had not changed markly. Conclusion: The contents of NO decreasing is relative to the severity of pancreatic necrosis.
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Objective To compare the detect abilities of obscure gastrointestinal bleeding by capsule endoscopies and conventional intestinal examinations.Methods To analyze the results of gastrointestinal barium meal examination, arteriography of superior mesenteric artery, push enteroscopy, capsule endoscopy, and enteroscopy during exploratory laparotomy in 67 patients with obscure gastrointestinal bleeding.Results Detectable rates of gastrointestinal barium meal examination, arteriography of superior mesenteric artery, push enteroscopy, capsule endoscopy, and enteroscopy during exploratory laparotomy are 17 6%, 13 4%, 32 0%, 80 6%, and 83 3% respectively, and their diagnostic rates are 13 8%, 13 4%, 32 0%, 67 7%, and 83 3% respectively. Conclusion Capsule endoscopy is superior to conventional methods of intestinal examinations having high detectable and diagnostic rates in obscure gastrointestinal bleeding; it should be the first choice in diagnosing obscure gastrointestinal bleeding.
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Objective To evaluate the diagnosis of intestinal bleeding by capsule endoscopy ( CE) , and compare with the result of operation. Methods All patients experienced CE had failed to get definite diagnosis from conventional endoscopy. Of 50 consecutive patients, 28 with intestinal bleeding episodes more than 5 times (group A) , 14 with 2-5 times(group B) and 8 with only oace (group C) ,totally 18 patients had received operation. Results Of these 50 patients, 39 ( 78. 0 % ) had abnormal findings, which could be considered as the etiology of bleeding. The detectable rate was 92. 9% , 71. 4% and 37. 5% in-group A, B, and C respectively (P
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Objective To retrospectively analyze the results of 52 cases with different diseases of alimentary tract treated by APC and evaluate its effectiveness and safety. Methods From April 2001 to May 2002, 52 cases with different digestive diseases were treated by APC under endoscopy , the disorders included 29 cases of GI bleeding (peptic ulcer 9, angiodysplasia 8, stoma bleeding 3, postpolypectomy bleeding 5 and flat crenated adenoma bleeding , duodenal angiodysplasia, multiple colon AVM and stoma bleeding of cardiac cancer, 1 in each) ,and 23 cases of polypoid lesion( esophagus and cardia polyps 5, flat esophageal lesion with dysplasia 1, Menetrier's disease 1, colon-rectal polyps 6, multiple polyps 5, and stump of giant sessile adenoma 4 and postoperative recurrence of cardia carcinoma 1). Results The theraputic results showed that only one GU case with artery spurting faild after APC therapy of bleeding ulcers, the hemostasis rate for all GI bleeding was 96. 5%. For the polyp smaller than 5mm in diameter, APC was the choice of treatment, but polypectomy with snare is suitable for bigger polyp or adenoma before APC for stump clearance, and the endocut (high-frequency e-lectron) was safe and effective for giant sessile adenomas, we had only one case with mucosa gas vacu-ole which had no clinical event. Conclusion APC has excellent effect of hemostasis on most non-porta-hypertensive GI bleeding except bigger artery spurting, and it combined with endocut is a safe and effective treatment of various polypoid lesions.
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Objective To investigate the early diagnosis and treatment of primary gastrointestinal malignant lymphoma( PGIML). Methods The clinical materials of 33 cases with PGIML from 1997 to 2005 were retrospectively studied. Results The diagnosis rate of gastroenteroscopy was 44. 4% . The most common immune phenotype was B-cell lineage (90. 9% ). Of the 33 PGIML patients, 30 were treated with operation, 2 with H. poli elimination and 1 gave up treatment. Among the operation cases and operation plus chemotherapy cases 19/21 cases (90. 5% )and 6/9 cases (66. 7% ) survived more than 2 years respectively, the other 6 cases died. Conclusion It is hard to diagnose PGIML in early stage. The effectiveness of surgery on treating PGIML should be further confirmed by profound prospective randomized trials.