BACKGROUND According to practice guidelines,endoscopic band ligation(EBL)and endoscopic tissue adhesive injection(TAI)are recommended for treating bleeding from esophagogastric varices.However,EBL and TAI are known to...BACKGROUND According to practice guidelines,endoscopic band ligation(EBL)and endoscopic tissue adhesive injection(TAI)are recommended for treating bleeding from esophagogastric varices.However,EBL and TAI are known to cause serious complications,such as hemorrhage from dislodged ligature rings caused by EBL and hemorrhage from operation-related ulcers resulting from TAI.However,the optimal therapy for mild to moderate type 1 gastric variceal hemorrhage(GOV1)has not been determined.Therefore,the aim of this study was to discover an individualized treatment for mild to moderate GOV1.AIM To compare the efficacy,safety and costs of EBL and TAI for the treatment of mild and moderate GOV1.METHODS A clinical analysis of the data retrieved from patients with mild or moderate GOV1 gastric varices who were treated under endoscopy was also conducted.Patients were allocated to an EBL group or an endoscopic TAI group.The differences in the incidence of varicose relief,operative time,operation success rate,mortality rate within 6 wk,rebleeding rate,6-wk operation-related ulcer healing rate,complication rate and average operation cost were compared between the two groups of patients.RESULTS The total effective rate of the two treatments was similar,but the efficacy of EBL(66.7%)was markedly better than that of TAI(39.2%)(P<0.05).The operation success rate in both groups was 100%,and the 6-wk mortality rate in both groups was 0%.The average operative time(26 min)in the EBL group was significantly shorter than that in the TAI group(46 min)(P<0.01).The rate of delayed postoperative rebleeding in the EBL group was significantly lower than that in the TAI group(11.8%vs 45.1%)(P<0.01).At 6 wk after the operation,the healing rate of operation-related ulcers in the EBL group was 80.4%,which was significantly greater than that in the TAI group(35.3%)(P<0.01).The incidence of postoperative complications in the two groups was similar.The average cost and other related economic factors were greater for the EBL than for the TAI(P<0.01).CONCLUSION For mild to moderate GOV1,patients with EBL had a greater one-time varix eradication rate,a greater 6-wk operation-related ulcer healing rate,a lower delayed rebleeding rate and a lower cost than patients with TAI.展开更多
BACKGROUND Klippel-Trenaunay syndrome(KTS) is a congenital vascular malformation with a complicated etiology. It is sporadic and clinically rare in occurrence. The typical characteristics are capillary malformation(al...BACKGROUND Klippel-Trenaunay syndrome(KTS) is a congenital vascular malformation with a complicated etiology. It is sporadic and clinically rare in occurrence. The typical characteristics are capillary malformation(also known as port-wine stain),varicose veins and malformations, and bony and/or soft tissue hypertrophy with or without lymphatic malformation, which are known as the “classic clinical triad”. Herein, a rare case of KTS characterized by crossed-bilateral limb hypertrophy accompanied by intermittent hematochezia and hematuria is reported.CASE SUMMARY We described a 37-year-old female with KTS. She was admitted to our hospital owing to the gradual enlargement of the left lower extremity along with intermittent hematochezia and hematuria. The patient was diagnosed to have hemorrhoid bleeding by other hospitals and treated with conventional hemostatic drugs, but continued to have intermittent gastrointestinal bleeding and hematuria. Therefore, she visited our hospital to seek further treatment. During hospitalization, relevant imaging and laboratory examinations and colonoscopy were performed. In combination with the patient’s history and relevant examinations, we considered that the patient had a complex form of KTS. We recommended a combined diagnosis and treatment from the vascular, interventional,anorectal, and other departments, although she declined any further treatment for financial reasons.CONCLUSION The clinical manifestations of KTS are extensive and diverse and chiefly include the typical triad. However, Vascular malformations of KTS can also involve several parts and systems such as digestive and urogenital systems. Therefore, the atypical manifestations and rare complications necessitate the clinician’s attention and are not to be ignored.展开更多
BACKGROUND Pancreatic pseudoaneurysm is a rare vascular complication of chronic pancreatitis(CP)or necrotizing pancreatitis with an incidence of 4%to 17%,but it is potentially life-threatening.It is well known that mo...BACKGROUND Pancreatic pseudoaneurysm is a rare vascular complication of chronic pancreatitis(CP)or necrotizing pancreatitis with an incidence of 4%to 17%,but it is potentially life-threatening.It is well known that most pancreatic pseudoaneurysms are clinically associated with pancreatic pseudocysts and are usually in the peripancreatic body-tail.A minority of intrapancreatic pseudoaneurysms occur in the absence of pseudocyst formation.Noninvasive computed tomography(CT)and magnetic resonance imaging(MRI)are most commonly used examinations for screening pancreatic pseudoaneurysms.Notably,the rare intrapancreatic pseudoaneurysm in the pancreatic head can mimic a hypervascular solid mass and be misdiagnosed as a pancreatic tumor.CASE SUMMARY We report the case of a 67-year-old man who had been admitted to our hospital due to recurrent abdominal pain for 1 mo that was aggravated for 5 d.CT and MRI revealed a mass in the pancreatic head with significant expansion of the main pancreatic duct and mild atrophy of the pancreatic body-tail.He was admitted to the department of hepatobiliary and pancreatic surgery due to the possibility of a pancreatic tumor.The patient was then referred for endoscopic ultrasonography(EUS)with possible EUS-FNA.However,EUS showed a cystic lesion in the pancreatic head with wall thickness and enhancing nodules,which was doubtful because it was inconsistent with the imaging findings.Subsequently,color doppler flow imaging demonstrated turbulent arterial blood flow in the cystic lesion and connection with the surrounding vessel.Therefore,we highly suspected the possibility of CP complicated with intrapancreatic pseudoaneurysm,combined with the patient's long-term drinking history and the sonographic features of CP.Indeed,angiography revealed an oval area of contrast medium extravasation(size:1.0 cm×1.5 cm)at the far-end branch of the superior pancreaticoduodenal artery,and angiographic embolization was given immediately at the same time.CONCLUSION EUS is an important differential diagnostic tool when pancreatic pseudoaneurysm mimics the imaging appearance of a hypervascular pancreatic tumor.展开更多
Organic anion transporters(OATs)and organic anion transporter polypeptides(OATPs)are classified within two SLC superfamilies,namely,the SLC22A superfamily and the SLCO superfamily(formerly the SLC21A family),respectiv...Organic anion transporters(OATs)and organic anion transporter polypeptides(OATPs)are classified within two SLC superfamilies,namely,the SLC22A superfamily and the SLCO superfamily(formerly the SLC21A family),respectively.They are expressed in many tissues,such as the liver and kidney,and mediate the absorption and excretion of many endogenous and exogenous substances,including various drugs.Most are composed of 12 transmembrane polypeptide chains with the C-terminus and the N-terminus located in the cell cytoplasm.OATs and OATPs are abundantly expressed in the liver,where they mainly promote the uptake of various endogenous substrates such as bile acids and various exogenous drugs such as antifibrotic and anticancer drugs.However,differences in the locations of glycosylation sites,phosphorylation sites,and amino acids in the OAT and OATP structures lead to different substrates being transported to the liver,which ultimately results in their different roles in the liver.To date,few articles have addressed these aspects of OAT and OATP structures,and we study further the similarities and differences in their structures,tissue distribution,substrates,and roles in liver diseases.展开更多
BACKGROUND Endoplasmic reticulum(ER)stress is an important mechanism in the progression of chronic and acute liver diseases,especially in the progression and recovery of liver fibrosis.Excessive and long-term ER stres...BACKGROUND Endoplasmic reticulum(ER)stress is an important mechanism in the progression of chronic and acute liver diseases,especially in the progression and recovery of liver fibrosis.Excessive and long-term ER stress induces apoptosis.ER stressinduced apoptosis is considered to be an important pathway in the development of liver fibrosis.Cyclooxygenase-2(COX-2)induction is also closely related to ER stress.In our previous studies,we showed that celecoxib,a COX-2 inhibitor,improves liver fibrosis and portal hypertension.However,the role and mechanism of celecoxib in alleviating liver fibrosis remain unclear.AIM To investigate whether celecoxib alleviates liver fibrosis by inhibiting hepatocyte apoptosis via the ER stress response.METHODS Cirrhosis was induced by intraperitoneal injections of thioacetamide(TAA)for 16 wk(injection dose is 200 mg/kg per 3 d for the first 8 wk and 100 mg/kg per 3 d after 8 wk).Thirty-six male Sprague-Dawley rats were randomly divided into three groups,namely,control group,TAA group,and TAA+celecoxib group.In the last 8 wk,TAA-induced cirrhotic rats received celecoxib(20 mg/kg/day)or the vehicle by gastric gavage.After 16 wk,the rats were sacrificed,and serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),and albumin(ALB)were detected.The hepatic fibrosis areas were evaluated by Sirius red staining and the degree of fibrosis was assessed by measuring the level of hydroxyproline.ER stress levels were evaluated by detecting the marker proteins glucose-regulated protein 78(GRP78),CCAAT/enhancer binding protein homologous protein(CHOP),PKR-like ER protein kinase(PERK),activating transcription factor 6(ATF6),and inositol-requiring enzyme 1 alpha(IRE1α).Apoptosis levels were evaluated by detecting caspase-12 and caspase-3.RESULTS The serum ALT and AST levels in the liver were significantly reduced by celecoxib;however,the serum ALB had no significant changes.Celecoxib significantly reduced the degree of liver fibrosis and the levels of hydroxyproline(-38%and-25.7%,respectively,P<0.01).Celecoxib ameliorated ER stress by reducing the level of GRP78 compared to the TAA group(P<0.05).Consistently,after celecoxib administration,the upregulation of TAA-induced hepatic apoptosis markers(caspase-12 and caspase-3)and CHOP were significantly inhibited.In addition,after celecoxib treatment,the expression of key molecules associated with ER stress(PERK,ATF6,and IRE1)was decreased(P<0.05).CONCLUSION Therapeutic administration of celecoxib effectively reduces hepatic apoptosis in TAA-induced cirrhotic rats.The mechanism of action may be attributed to the suppression of CHOP expression,which subsequently inhibits ER stress.展开更多
Neurofibromatosis type 1(NF-1) is commonly associated with benign or malignant tumors in both the central and peripheral nervous systems. However, rare cases of NF-1-associated multiplerectal neuroendocrine tumors hav...Neurofibromatosis type 1(NF-1) is commonly associated with benign or malignant tumors in both the central and peripheral nervous systems. However, rare cases of NF-1-associated multiplerectal neuroendocrine tumors have been reported. This report describes a case of a 39 year old female with NF-1 and intermittent hematochezia as a primary symptom. Physical examination showed multiple subcutaneous nodules and café au lait spots with obvious scoliosis of the back. Imaging examinations and colonoscopy found malformation of the left external iliac vein and multiple gray-yellow nodules with varying sizes and shapes in the rectal submucosal layer. Histological and immunohistochemical results suggested multiple rectal neuroendocrine tumors, a rare disease with few appreciable symptoms and a particularly poor prognosis. The patient with NF-1 presented here had not only multiple rectal neuroendocrine neoplasms but also vascular malformations, scoliosis and other multiple system lesions. This case therefore contributes to improving clinical understanding, diagnosis and treatment of related complications for patients with NF-1 who present with associated medical conditions.展开更多
BACKGROUND Ingestion of foreign bodies results in gastrointestinal perforation in approximately 1% of patients,and fish bones are the objects that most commonly lead to bowel perforation. When it does occur,the termin...BACKGROUND Ingestion of foreign bodies results in gastrointestinal perforation in approximately 1% of patients,and fish bones are the objects that most commonly lead to bowel perforation. When it does occur,the terminal ileum is the most common site of perforation,followed by the duodenal C-loop. However,involvement of the pancreas is very rare. Because clinical symptoms are nonspecific and gastrointestinal perforation may present as only odynophagia or abdominal pain,a definite preoperative diagnosis and clinical intervention may be delayed.CASE SUMMARY We report the case of a 32-year-old man who presented to our hospital because of abdominal pain that had worsened over 5 d. He had no significant past history except that he had eaten fish 1 wk previously. Upper endoscopy revealed an irregular submucosal tumor on the front wall of the gastric antrum. Endoscopic ultrasonography and computed tomography showed a fish bone penetrating the gastric antrum and migratingin to the neck of the pancreas. The patient underwent laparoscopic surgery and had no complications one week after the operation.CONCLUSION A recent history of foreign body ingestion and imaging examinations are helpful for diagnosis of unexplained abdominal pain caused by foreign bodies.展开更多
BACKGROUND Mucosa-associated lymphoid tissue(MALT)lymphoma occurs largely in the digestive tract,with the stomach being the most commonly affected organ,followed by the small intestine,large intestine,and esophagus.It...BACKGROUND Mucosa-associated lymphoid tissue(MALT)lymphoma occurs largely in the digestive tract,with the stomach being the most commonly affected organ,followed by the small intestine,large intestine,and esophagus.It is rarely found in both the stomach and colon.Helicobacter pylori(H.pylori)infection is strongly associated with gastric MALT lymphoma,although there is a small number of H.pylori-negative gastric MALT lymphomas.Diagnosis of MALT lymphoma is challenging because of nonspecific symptoms and diverse presentations of endoscopic findings.CASE SUMMARY We report a case of an asymptomatic patient who during screening endoscopy and was found to have stromal tumor-like submucosal uplift lesions in the stomach body and polypoid lesions in the rectum.After endoscopic resection,the patient was diagnosed with multiple early simultaneous gastrointestinal MALT lymphomas.CONCLUSION This study may help improve our understanding of MALT lymphomas and multifocal lesions treated using early endoscopy.展开更多
BACKGROUND Pancreatic pseudocyst may cause serious gastrointestinal complications including necrosis,infection,and perforation of the gastrointestinal tract wall,but massive gastric bleeding is very rare.CASE We repor...BACKGROUND Pancreatic pseudocyst may cause serious gastrointestinal complications including necrosis,infection,and perforation of the gastrointestinal tract wall,but massive gastric bleeding is very rare.CASE We report a rare case of a 49-year-old man with life-threatening gastric bleeding from a pseudoaneurysm of the splenic artery perforating the stomach induced by pancreatic pseudocyst.During hospitalization,gastroscopy revealed a bare blood vessel in an ulcer-like depression of the greater gastric curvature,and computed tomography scan confirmed a pancreatic pseudocyst invading part of the spleen and gastric wall of the greater curvature.Arteriography showed that the bare blood vessel originated from a pseudoaneurysm of the splenic artery.The bleeding was controlled by the trans-arterial embolization,the patient’s recovery was rapid and uneventful.CONCLUSION Massive gastrointestinal bleeding could be a rare complication of pancreatic pseudo aneurysm.展开更多
BACKGROUND Localized primary gastric amyloidosis is a rare disorder characterized by the extracellular deposition of insoluble fibrillary protein in the stomach and can mimic various diseases on endoscopic examination...BACKGROUND Localized primary gastric amyloidosis is a rare disorder characterized by the extracellular deposition of insoluble fibrillary protein in the stomach and can mimic various diseases on endoscopic examination,including gastrointestinal stromal tumors,gastric cancer and ulcers.CASE SUMMARIES Here,we report a series of three cases of localized gastric amyloidosis mimicking gastric mucosa-associated lymphoid tissue(MALT)lymphoma on endoscopic examination that were evaluated over the past ten years in our hospital.The different detection times of this rare disease resulted in three completely different outcomes,indicating the strong importance of early detection,diagnosis and treatment.The difficulties encountered in making an accurate diagnosis and differential diagnosis are highlighted,and this report provides clinical experience for the diagnosis of localized primary gastric amyloidosis.CONCLUSION Localized gastric amyloidosis is a rare metabolic disease that resembles MALT lymphoma.Early detection,diagnosis and treatment of localized gastric amyloidosis result in an excellent prognosis.展开更多
基金Supported by the Guizhou Provincial Science and Technology Program,No.[2020]4Y004.
文摘BACKGROUND According to practice guidelines,endoscopic band ligation(EBL)and endoscopic tissue adhesive injection(TAI)are recommended for treating bleeding from esophagogastric varices.However,EBL and TAI are known to cause serious complications,such as hemorrhage from dislodged ligature rings caused by EBL and hemorrhage from operation-related ulcers resulting from TAI.However,the optimal therapy for mild to moderate type 1 gastric variceal hemorrhage(GOV1)has not been determined.Therefore,the aim of this study was to discover an individualized treatment for mild to moderate GOV1.AIM To compare the efficacy,safety and costs of EBL and TAI for the treatment of mild and moderate GOV1.METHODS A clinical analysis of the data retrieved from patients with mild or moderate GOV1 gastric varices who were treated under endoscopy was also conducted.Patients were allocated to an EBL group or an endoscopic TAI group.The differences in the incidence of varicose relief,operative time,operation success rate,mortality rate within 6 wk,rebleeding rate,6-wk operation-related ulcer healing rate,complication rate and average operation cost were compared between the two groups of patients.RESULTS The total effective rate of the two treatments was similar,but the efficacy of EBL(66.7%)was markedly better than that of TAI(39.2%)(P<0.05).The operation success rate in both groups was 100%,and the 6-wk mortality rate in both groups was 0%.The average operative time(26 min)in the EBL group was significantly shorter than that in the TAI group(46 min)(P<0.01).The rate of delayed postoperative rebleeding in the EBL group was significantly lower than that in the TAI group(11.8%vs 45.1%)(P<0.01).At 6 wk after the operation,the healing rate of operation-related ulcers in the EBL group was 80.4%,which was significantly greater than that in the TAI group(35.3%)(P<0.01).The incidence of postoperative complications in the two groups was similar.The average cost and other related economic factors were greater for the EBL than for the TAI(P<0.01).CONCLUSION For mild to moderate GOV1,patients with EBL had a greater one-time varix eradication rate,a greater 6-wk operation-related ulcer healing rate,a lower delayed rebleeding rate and a lower cost than patients with TAI.
基金Supported by the Basic Research Projects of Science and Technology Department of Guizhou Province,No. Qian Ke He-zk[2022]-646Master Start-up Foundation of Affiliated Hospital of Zunyi Medical College,No. 2016-45Collaborative Innovation Center of Chinese Ministry of Education,No. 2020-39。
文摘BACKGROUND Klippel-Trenaunay syndrome(KTS) is a congenital vascular malformation with a complicated etiology. It is sporadic and clinically rare in occurrence. The typical characteristics are capillary malformation(also known as port-wine stain),varicose veins and malformations, and bony and/or soft tissue hypertrophy with or without lymphatic malformation, which are known as the “classic clinical triad”. Herein, a rare case of KTS characterized by crossed-bilateral limb hypertrophy accompanied by intermittent hematochezia and hematuria is reported.CASE SUMMARY We described a 37-year-old female with KTS. She was admitted to our hospital owing to the gradual enlargement of the left lower extremity along with intermittent hematochezia and hematuria. The patient was diagnosed to have hemorrhoid bleeding by other hospitals and treated with conventional hemostatic drugs, but continued to have intermittent gastrointestinal bleeding and hematuria. Therefore, she visited our hospital to seek further treatment. During hospitalization, relevant imaging and laboratory examinations and colonoscopy were performed. In combination with the patient’s history and relevant examinations, we considered that the patient had a complex form of KTS. We recommended a combined diagnosis and treatment from the vascular, interventional,anorectal, and other departments, although she declined any further treatment for financial reasons.CONCLUSION The clinical manifestations of KTS are extensive and diverse and chiefly include the typical triad. However, Vascular malformations of KTS can also involve several parts and systems such as digestive and urogenital systems. Therefore, the atypical manifestations and rare complications necessitate the clinician’s attention and are not to be ignored.
基金Supported by Guizhou Provincial Basic Research Program(Natural Science),No.QIAN KE HE JI CHU-ZK(2023)YI BAN 558Collaborative Innovation Center of Chinese Ministry of Education,No.2020-39.
文摘BACKGROUND Pancreatic pseudoaneurysm is a rare vascular complication of chronic pancreatitis(CP)or necrotizing pancreatitis with an incidence of 4%to 17%,but it is potentially life-threatening.It is well known that most pancreatic pseudoaneurysms are clinically associated with pancreatic pseudocysts and are usually in the peripancreatic body-tail.A minority of intrapancreatic pseudoaneurysms occur in the absence of pseudocyst formation.Noninvasive computed tomography(CT)and magnetic resonance imaging(MRI)are most commonly used examinations for screening pancreatic pseudoaneurysms.Notably,the rare intrapancreatic pseudoaneurysm in the pancreatic head can mimic a hypervascular solid mass and be misdiagnosed as a pancreatic tumor.CASE SUMMARY We report the case of a 67-year-old man who had been admitted to our hospital due to recurrent abdominal pain for 1 mo that was aggravated for 5 d.CT and MRI revealed a mass in the pancreatic head with significant expansion of the main pancreatic duct and mild atrophy of the pancreatic body-tail.He was admitted to the department of hepatobiliary and pancreatic surgery due to the possibility of a pancreatic tumor.The patient was then referred for endoscopic ultrasonography(EUS)with possible EUS-FNA.However,EUS showed a cystic lesion in the pancreatic head with wall thickness and enhancing nodules,which was doubtful because it was inconsistent with the imaging findings.Subsequently,color doppler flow imaging demonstrated turbulent arterial blood flow in the cystic lesion and connection with the surrounding vessel.Therefore,we highly suspected the possibility of CP complicated with intrapancreatic pseudoaneurysm,combined with the patient's long-term drinking history and the sonographic features of CP.Indeed,angiography revealed an oval area of contrast medium extravasation(size:1.0 cm×1.5 cm)at the far-end branch of the superior pancreaticoduodenal artery,and angiographic embolization was given immediately at the same time.CONCLUSION EUS is an important differential diagnostic tool when pancreatic pseudoaneurysm mimics the imaging appearance of a hypervascular pancreatic tumor.
文摘Organic anion transporters(OATs)and organic anion transporter polypeptides(OATPs)are classified within two SLC superfamilies,namely,the SLC22A superfamily and the SLCO superfamily(formerly the SLC21A family),respectively.They are expressed in many tissues,such as the liver and kidney,and mediate the absorption and excretion of many endogenous and exogenous substances,including various drugs.Most are composed of 12 transmembrane polypeptide chains with the C-terminus and the N-terminus located in the cell cytoplasm.OATs and OATPs are abundantly expressed in the liver,where they mainly promote the uptake of various endogenous substrates such as bile acids and various exogenous drugs such as antifibrotic and anticancer drugs.However,differences in the locations of glycosylation sites,phosphorylation sites,and amino acids in the OAT and OATP structures lead to different substrates being transported to the liver,which ultimately results in their different roles in the liver.To date,few articles have addressed these aspects of OAT and OATP structures,and we study further the similarities and differences in their structures,tissue distribution,substrates,and roles in liver diseases.
基金the National Natural Science Fund of China,No.U1702281,No.81670551,and No.81873584.
文摘BACKGROUND Endoplasmic reticulum(ER)stress is an important mechanism in the progression of chronic and acute liver diseases,especially in the progression and recovery of liver fibrosis.Excessive and long-term ER stress induces apoptosis.ER stressinduced apoptosis is considered to be an important pathway in the development of liver fibrosis.Cyclooxygenase-2(COX-2)induction is also closely related to ER stress.In our previous studies,we showed that celecoxib,a COX-2 inhibitor,improves liver fibrosis and portal hypertension.However,the role and mechanism of celecoxib in alleviating liver fibrosis remain unclear.AIM To investigate whether celecoxib alleviates liver fibrosis by inhibiting hepatocyte apoptosis via the ER stress response.METHODS Cirrhosis was induced by intraperitoneal injections of thioacetamide(TAA)for 16 wk(injection dose is 200 mg/kg per 3 d for the first 8 wk and 100 mg/kg per 3 d after 8 wk).Thirty-six male Sprague-Dawley rats were randomly divided into three groups,namely,control group,TAA group,and TAA+celecoxib group.In the last 8 wk,TAA-induced cirrhotic rats received celecoxib(20 mg/kg/day)or the vehicle by gastric gavage.After 16 wk,the rats were sacrificed,and serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),and albumin(ALB)were detected.The hepatic fibrosis areas were evaluated by Sirius red staining and the degree of fibrosis was assessed by measuring the level of hydroxyproline.ER stress levels were evaluated by detecting the marker proteins glucose-regulated protein 78(GRP78),CCAAT/enhancer binding protein homologous protein(CHOP),PKR-like ER protein kinase(PERK),activating transcription factor 6(ATF6),and inositol-requiring enzyme 1 alpha(IRE1α).Apoptosis levels were evaluated by detecting caspase-12 and caspase-3.RESULTS The serum ALT and AST levels in the liver were significantly reduced by celecoxib;however,the serum ALB had no significant changes.Celecoxib significantly reduced the degree of liver fibrosis and the levels of hydroxyproline(-38%and-25.7%,respectively,P<0.01).Celecoxib ameliorated ER stress by reducing the level of GRP78 compared to the TAA group(P<0.05).Consistently,after celecoxib administration,the upregulation of TAA-induced hepatic apoptosis markers(caspase-12 and caspase-3)and CHOP were significantly inhibited.In addition,after celecoxib treatment,the expression of key molecules associated with ER stress(PERK,ATF6,and IRE1)was decreased(P<0.05).CONCLUSION Therapeutic administration of celecoxib effectively reduces hepatic apoptosis in TAA-induced cirrhotic rats.The mechanism of action may be attributed to the suppression of CHOP expression,which subsequently inhibits ER stress.
文摘Neurofibromatosis type 1(NF-1) is commonly associated with benign or malignant tumors in both the central and peripheral nervous systems. However, rare cases of NF-1-associated multiplerectal neuroendocrine tumors have been reported. This report describes a case of a 39 year old female with NF-1 and intermittent hematochezia as a primary symptom. Physical examination showed multiple subcutaneous nodules and café au lait spots with obvious scoliosis of the back. Imaging examinations and colonoscopy found malformation of the left external iliac vein and multiple gray-yellow nodules with varying sizes and shapes in the rectal submucosal layer. Histological and immunohistochemical results suggested multiple rectal neuroendocrine tumors, a rare disease with few appreciable symptoms and a particularly poor prognosis. The patient with NF-1 presented here had not only multiple rectal neuroendocrine neoplasms but also vascular malformations, scoliosis and other multiple system lesions. This case therefore contributes to improving clinical understanding, diagnosis and treatment of related complications for patients with NF-1 who present with associated medical conditions.
文摘BACKGROUND Ingestion of foreign bodies results in gastrointestinal perforation in approximately 1% of patients,and fish bones are the objects that most commonly lead to bowel perforation. When it does occur,the terminal ileum is the most common site of perforation,followed by the duodenal C-loop. However,involvement of the pancreas is very rare. Because clinical symptoms are nonspecific and gastrointestinal perforation may present as only odynophagia or abdominal pain,a definite preoperative diagnosis and clinical intervention may be delayed.CASE SUMMARY We report the case of a 32-year-old man who presented to our hospital because of abdominal pain that had worsened over 5 d. He had no significant past history except that he had eaten fish 1 wk previously. Upper endoscopy revealed an irregular submucosal tumor on the front wall of the gastric antrum. Endoscopic ultrasonography and computed tomography showed a fish bone penetrating the gastric antrum and migratingin to the neck of the pancreas. The patient underwent laparoscopic surgery and had no complications one week after the operation.CONCLUSION A recent history of foreign body ingestion and imaging examinations are helpful for diagnosis of unexplained abdominal pain caused by foreign bodies.
基金Supported by Master's Start-up Fund of the Affiliated Hospital of Zunyi Medical College,No.[2015]34Basic Research Projects of Science and Technology Department of Guizhou Province,No.Qian Ke He-zk[2022]-646Collaborative Innovation Center of Chinese Ministry of Education,No.2020-39.
文摘BACKGROUND Mucosa-associated lymphoid tissue(MALT)lymphoma occurs largely in the digestive tract,with the stomach being the most commonly affected organ,followed by the small intestine,large intestine,and esophagus.It is rarely found in both the stomach and colon.Helicobacter pylori(H.pylori)infection is strongly associated with gastric MALT lymphoma,although there is a small number of H.pylori-negative gastric MALT lymphomas.Diagnosis of MALT lymphoma is challenging because of nonspecific symptoms and diverse presentations of endoscopic findings.CASE SUMMARY We report a case of an asymptomatic patient who during screening endoscopy and was found to have stromal tumor-like submucosal uplift lesions in the stomach body and polypoid lesions in the rectum.After endoscopic resection,the patient was diagnosed with multiple early simultaneous gastrointestinal MALT lymphomas.CONCLUSION This study may help improve our understanding of MALT lymphomas and multifocal lesions treated using early endoscopy.
基金The National Natural Science Foundation of China,No.81660412(to Rui Xie).
文摘BACKGROUND Pancreatic pseudocyst may cause serious gastrointestinal complications including necrosis,infection,and perforation of the gastrointestinal tract wall,but massive gastric bleeding is very rare.CASE We report a rare case of a 49-year-old man with life-threatening gastric bleeding from a pseudoaneurysm of the splenic artery perforating the stomach induced by pancreatic pseudocyst.During hospitalization,gastroscopy revealed a bare blood vessel in an ulcer-like depression of the greater gastric curvature,and computed tomography scan confirmed a pancreatic pseudocyst invading part of the spleen and gastric wall of the greater curvature.Arteriography showed that the bare blood vessel originated from a pseudoaneurysm of the splenic artery.The bleeding was controlled by the trans-arterial embolization,the patient’s recovery was rapid and uneventful.CONCLUSION Massive gastrointestinal bleeding could be a rare complication of pancreatic pseudo aneurysm.
基金the National Natural Science Foundation of China,No.81860103,No.81560456,No.81660098 and No.81572438and the Outstanding Scientific Youth Fund of Guizhou Province,No.2017-5608.
文摘BACKGROUND Localized primary gastric amyloidosis is a rare disorder characterized by the extracellular deposition of insoluble fibrillary protein in the stomach and can mimic various diseases on endoscopic examination,including gastrointestinal stromal tumors,gastric cancer and ulcers.CASE SUMMARIES Here,we report a series of three cases of localized gastric amyloidosis mimicking gastric mucosa-associated lymphoid tissue(MALT)lymphoma on endoscopic examination that were evaluated over the past ten years in our hospital.The different detection times of this rare disease resulted in three completely different outcomes,indicating the strong importance of early detection,diagnosis and treatment.The difficulties encountered in making an accurate diagnosis and differential diagnosis are highlighted,and this report provides clinical experience for the diagnosis of localized primary gastric amyloidosis.CONCLUSION Localized gastric amyloidosis is a rare metabolic disease that resembles MALT lymphoma.Early detection,diagnosis and treatment of localized gastric amyloidosis result in an excellent prognosis.
