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OBJECTIVE: To determine the diagnostic value of digital subtraction angiography (DSA) in detecting small intestinal bleeding. METHODS: DSA was performed in 39 patients with suspected small intestinal bleeding. The sensitivity, specificity and accuracy of DSA were evaluated in the 25 patients who accepted surgical treatment. RESULTS: Among the 39 patients, 33 came out with positive in DSA. Eight patients were given interventional embolization successfully. The sensitivity, specificity and accuracy of DSA in detecting small intestinal bleeding were 91.7%, 100% and 92% respectively. The pathological results confirmed 77.3% of etiological diagnosis by DSA. CONCLUSION: DSA is an effective method for detecting small intestinal hemorrhage. The accurate diagnosis can guide the intervention with embolization.
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Angiografia Digital/métodos , Hemorragia Gastrointestinal/diagnóstico por imagem , Enteropatias/diagnóstico por imagem , Intestino Delgado/irrigação sanguínea , Intestino Delgado/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hemorragia Gastrointestinal/cirurgia , Humanos , Enteropatias/cirurgia , Intestino Delgado/cirurgia , Masculino , Pessoa de Meia-Idade , Sensibilidade e EspecificidadeRESUMO
Objective To analyze the correlation between irritable bowel syndrome(IBS)as well as its subtypes and gallbladder stone.Methods Collected the clinical data of 556 patients who were treated in Department of Gastroenterology of the Sixth Medical Center of Chinese PLA General Hospital from January 2019 to March 2023.The patients were divided into IBS group(n=161)and non-IBS group(n=395).The subjects were investigated by questionnaire,physical examination and blood examination,and the data of gender,age,height,weight,blood pressure and blood biochemical indexes were obtained and compared between two groups.The relation between gallbladder stone and IBS were evaluated by logistic regression analysis.Results There were 90 cases of gallbladder stone in the total population,accounting for 16.2%,including 37 cases of gallbladder stone in IBS group(23.0%)and 53 cases in non-IBS group(13.4%).The prevalence rate of gallbladder stone in IBS group was significantly higher than that in non-IBS group(P<0.05).There were 6 cases of gallbladder muddy stones(3.7%)in IBS group and 3 cases(0.8%)in non-IBS group.And the prevalence rate of gallbladder muddy stones in IBS group was also significantly higher than that in non-IBS group(P<0.05).Logistic regression analysis showed that the age,BMI,total bile acids(TBA),total cholesterol(TC)and combined IBS were independently related to the occurrence of gallbladder stone(P<0.05).In the 161 IBS patients,there were 114 cases of diarrhea-predominant IBS(IBS-D group),including 26 cases(22.8%)of gallbladder stone in IBS-diarrhea(IBS-D,n=114)group and 47 cases of constipation-predominant IBS(IBS-C group),including 11 cases(23.4%)of gallbladder stone.And there were 53 cases(13.4%)of gallbladder stone in the non-IBS group(n=395).Further analysis showed that the prevalence rate of gallbladder stone in IBS-D group was significantly higher than that in non-IBS group(P<0.05).There was no significant difference in gallbladder stone prevalence rate between IBS-C group and non-IBS group(P>0.05).Conclusions There is a correlation between IBS and gallbladder stones.In addition,among the two subtypes of IBS,IBS-D patients may have an increased risk of gallbladder stone compared with non-IBS patients.
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Hidrotórax/diagnóstico , Hidrotórax/terapia , Cirrose Hepática/complicações , Derivação Portossistêmica Transjugular Intra-Hepática , Ascite/diagnóstico , Ascite/etiologia , Ascite/terapia , Diagnóstico por Imagem/métodos , Humanos , Hidrotórax/etiologia , Hipertensão Portal/complicações , Transplante de Fígado , Derrame Pleural/diagnóstico , Derrame Pleural/etiologia , Derrame Pleural/terapiaRESUMO
<p><b>PURPOSE</b>To compare the therapeutic effects of different doses of intravenous esomeprazole on treating trauma patients with stress ulcer bleeding.</p><p><b>METHODS</b>A total of 102 trauma patients with stress ulcer bleeding were randomly divided into 2 groups: 52 patients were assigned to the high-dose group who received 80 mg intravenous esomeprazole, and then 8 mg/h continuous infusion for 3 days; 50 patients were assigned to the conventional dose group who received 40 mg intravenous esomeprazole sodium once every 12 h for 72 h.</p><p><b>RESULTS</b>Compared with the conventional dose group, the total efficiency of the high-dose group and conventional dose group was 98.08% and 86.00%, respectively (p < 0.05), the hemostatic time was 22.10 h ± 5.18 h and 28.27 h ± 5.96 h, respectively (p < 0.05).</p><p><b>CONCLUSION</b>Both doses of intravenous esomeprazole have good hemostatic effects on stress ulcer bleeding in trauma patients. The high-dose esomeprazole is better for hemostasis.</p>
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Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antiulcerosos , Usos Terapêuticos , Relação Dose-Resposta a Droga , Esomeprazol , Usos Terapêuticos , Úlcera Péptica Hemorrágica , Tratamento Farmacológico , Úlcera Gástrica , Estresse Psicológico , Ferimentos e LesõesRESUMO
To investigate the known and new factors associated with uninvestigated dyspepsia (UD), we surveyed 8600 Chinese navy personnel with offshore training shorter than 1 month or longer than 9 months per year. All respondents were required to complete a questionnaire covering demographics, the Chinese version of the Rome III survey, eating habits, life styles, and medical and family history. The response rate was 94.3% (8106/8600) with 4899 respondents qualified for analysis, including 1046 with offshore training and 3853 with onshore training. The prevalence of UD was higher in the offshore group than in the onshore group (12.6% vs. 6.9%, P<0.001), with a general prevalence of 8.1%. The subjects with offshore training were more likely to suffer from UD and postprandial distress syndrome (OR=1.955, 95% CI 1.568-2.439, P<0.001 and OR=1.789, 95% CI 1.403-2.303, P<0.001, respectively). The multivariate logistic regression analysis showed UD was associated with offshore training (OR=1.580, 95% CI 1.179-2.118, P=0.002), family history (OR=1.765, 95% CI 1.186-2.626, P=0.005) and smoking (OR=1.270, 95% CI 1.084-1.488, P=0.003), but not with alcohol drinking. The association between dysentery history and UD was undetermined/borderline (P=0.056-0.069). In conclusion, we identified offshore training as a new factor associated with UD, and also confirmed 2 known associated factors, family history and smoking.
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Adulto , Feminino , Humanos , Masculino , China , Epidemiologia , Dispepsia , Epidemiologia , Medicina Militar , Militares , Medicina NavalRESUMO
To investigate the known and new factors associated with uninvestigated dyspepsia (UD), we surveyed 8600 Chinese navy personnel with offshore training shorter than 1 month or longer than 9 months per year. All respondents were required to complete a questionnaire covering demographics, the Chinese version of the Rome III survey, eating habits, life styles, and medical and family history. The response rate was 94.3% (8106/8600) with 4899 respondents qualified for analysis, including 1046 with offshore training and 3853 with onshore training. The prevalence of UD was higher in the offshore group than in the onshore group (12.6% vs. 6.9%, P<0.001), with a general prevalence of 8.1%. The subjects with offshore training were more likely to suffer from UD and postprandial distress syndrome (OR=1.955, 95% CI 1.568-2.439, P<0.001 and OR=1.789, 95% CI 1.403-2.303, P<0.001, respectively). The multivariate logistic regression analysis showed UD was associated with offshore training (OR=1.580, 95% CI 1.179-2.118, P=0.002), family history (OR=1.765, 95% CI 1.186-2.626, P=0.005) and smoking (OR=1.270, 95% CI 1.084-1.488, P=0.003), but not with alcohol drinking. The association between dysentery history and UD was undetermined/borderline (P=0.056-0.069). In conclusion, we identified offshore training as a new factor associated with UD, and also confirmed 2 known associated factors, family history and smoking.
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<p><b>OBJECTIVE</b>To analyze functional dyspepsia prevalence and associated factors of naval forces.</p><p><b>METHOD</b>By stratified random cluster sampling method, conducted a questionnaire survey and diagnosis of functional dyspepsia to 11 520 military sea forces, and analyzed risk in clinical factors. Large sample size of 3084 cases in the diagnosis of functional dyspepsia, analyzed correlation of the selected 100 patients by single sample random sampling method.</p><p><b>RESULT</b>Naval forces, functional dyspepsia prevalence was 29.27% (3084/10537), and logistic regression analysis showed that job factors of military service, military rank, the nature of the work, the training intensity, training environmental P = 0.028, 0.023, 0.000, 0.000, 0.014, OR = 10.308, 6.288, 22.504, 26.720, 9.825; life factors of daily water intake, eating fruits and frequency of sleep time, spicy eating habits, drinking history factors P = 0.000, 0.012, 0.025, 0.017, 0.027, OR = 28.467, 20.335, 11.358, 10.249, 9.578; psychological factors, depression, anxiety factor P = 0.024, 0.019, OR = 16.878, 18.025;generally age, gender, ethnicity, BMI index, gastrointestinal history, history of drug, educational background, geographic factors P = 0.042, 0.033, 0.417, 0.000, 0.000, 0.012, 0.392, 0.440, OR = 3.406, 7.511, 2.643, 42.073, 88.457, 21.680, 1.752, 5.561.When value of P < 0.05, clinical risk factors were screened. Clinical symptom scores and work, life factor score and SAS, SDS score of randomly selected patient samples was positively correlated, r = 0.816, 0.763, 0.795, 0.923, P = 0.000, indicating statistically significant.</p><p><b>CONCLUSION</b>Naval forces functional dyspepsia prevalence was higher than the general population, which risk factors included work, life, psychological, physical fitness factors, closely related with military service and military personnel, military rank, the nature of the work, the training intensity and environment, eating habits, daily sleep time, drinking history, depression, anxiety level, age, gender, BMI index, history of gastrointestinal disease, use of drugs, high priority should be given to the risk factors listed above, the development of rational targeted programs to strengthen the cause of prevention measures.</p>
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Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , China , Epidemiologia , Dispepsia , Epidemiologia , Militares , Prevalência , Fatores de RiscoRESUMO
Background The afferent signals of proprioceptor in extraocular muscles play an important role in controlling eye position and conjugate movement. Palisade ending in the extraocular muscles is the main source of proprioceptive information, and its abnormalities in structure and function may be associated with the occurrence of nystagmus. Objective This study was to observe the changes of palisade ending in the extraocular muscles of patients with congenital nystagmus ( CN) and discuss the probable mechanism. Methods Modified Kestenbaum procedure was performed on 10 patients with CN, and the extraocular muscle samples were collected during the operation. Normal extraocular muscle samples were obtained from the enucleated eyeballs after ocular wound. The ultrathin sections of extraocular muscles were prepared and double-staining by uranyl acetate and lead citrate. The morphological changes of the palisade ending of extraocular muscles were examined under the transmission electron microscopy. Written informed consent was obtained from each subject before surgery. Results The ultrastructure of palisade ending in the extraocular muscle of CN subjects showed the different degrees of alterations. The mild changes included the collapse and disconnection of external capsules and the nonhomogeneous electron-dense substracts. The degeneration and dissociation of myelin in nerve endings, swelling and vacuolation of mitochondria were also exhibited. Myeloid body was found in axon. In the severe patients,the necrosis of Schwann' s cells,dissolve of axon and disappear of capsules were seen. Conclusion The palisade ending of extraocular muscle in the patients with CN are obviously abnormal in comparison with normal one. These alterations are probably associated with the etiology and pathogenesis of CN.
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<p><b>OBJECTIVE</b>To study the mutation of FRMD7 gene in a Chinese family with congenital idiopathic nystagmus.</p><p><b>METHODS</b>Forty-six individuals in the Chinese family with congenital idiopathic nystagmus, including 16 patients, 19 normal siblings and 11 spouses, were investigated under informed consent. Genomic DNA of all 46 members was isolated by standard protocol. The X-linked inherited pattern was ascertained by investigating the history of the family members and the clinical feature of each individual. The genome scan on X chromosome was performed after PCR amplification for microsatellite markers. LOD scores were calculated with Linkage 5.1. Direct DNA sequence analysis was carried out to find the gene mutation responsible for the disease.</p><p><b>RESULTS</b>A maximum LOD score of 8.55 (theta=0) was obtained with polymorphic marker DXS1047. Haplotype construction of the family defined the disease interval between DXS8059 and DXS8033. Direct DNA sequence analysis revealed a heterozygous mutation of G990T in exon 9 of the FRMD7 gene in all patients, which was not present in unaffected family members.</p><p><b>CONCLUSION</b>Congenital nystagmus is a clinically and genetically heterogeneous ocular movement disease. The mutation of G990T of the FRMD7 gene is the underlying molecular pathogenesis for this family with congenital nystagmus.</p>