Accidentally swallowed foreign objects are not uncommon but difficult to manage without complications. We describe the case of a 68 year old man who accidentally a swallowed sharp-pointed dental reamer that had reache...Accidentally swallowed foreign objects are not uncommon but difficult to manage without complications. We describe the case of a 68 year old man who accidentally a swallowed sharp-pointed dental reamer that had reached deep in his jejunum. Double balloon enteroscopic retrieval was performed with polypectomy snare but the reamer was entangled in the wire loop of the snare and penetrated the jejunal wall. After releasing the reamer by pushing and pulling the snare for approximately 30 min, the reamer was retrieved with biopsy forceps. This is the first report of double balloon enteroscopic removal of a dental reamer. Furthermore, this is a novel case with regard to decision making in situations when sharp objects are swallowed.展开更多
AIM: To study the distribution of the constitutive nitric oxide synthase (NOS) in the jejunum of adult rat. METHODS: The distribution of endothelial NOS (eNOS) was detected by immunohistochemistry. Immunofluorescence ...AIM: To study the distribution of the constitutive nitric oxide synthase (NOS) in the jejunum of adult rat. METHODS: The distribution of endothelial NOS (eNOS) was detected by immunohistochemistry. Immunofluorescence histochemical dual staining technique were used for studying the distribution of neuronal NOS (nNOS) and eNOS. The dual stained slides were observed under a confocal laser scanning microscope. RESULTS: Positive neuronal NOS (nNOS) and endothelial NOS (eNOS) cells were found to be distributed in lamina propria of villi, and the epithelial cell was not stained. eNOS was mainly located in submucosal vascular endothelia, while nNOS was mainly situated in myenteric plexus. Some cells in the villi had both nNOS and eNOS. More than 80% of the cells were positive for both nNOS and eNOS, the rest cells were positive either for nNOS or for eNOS. CONCLUSION: The two constitutive nitric oxide synthases are distributed differently in the jejunum of rat. nNOS distributed in myenteric plexus is a neurotransmitter in the non-adrenergic non-cholinergic (NANC) inhibitory nerves. eNOS distributed in endothelial and smooth muscle cells of blood vessels plays vasodilator role. eNOS and nNOS are coexpressed in some cells of lamina propria of villi. NO generated by those NOS is very important in the physiological and pathological process of small intestine.展开更多
[ Objective] This study aimed to investigate the effects of crude extract of Poria cocos on intestinal smooth muscle contraction of rabbits in vitro and re- veal the related mechanism. [Method] With in vitro experimen...[ Objective] This study aimed to investigate the effects of crude extract of Poria cocos on intestinal smooth muscle contraction of rabbits in vitro and re- veal the related mechanism. [Method] With in vitro experimental method, using the tension of jejunal and cecal smooth muscle as an indicator, 3.75, 7.50, 15.00, and 22.5 g/L crude extract of P. cocos were added into Tyrede＇s solution of jejunum and cecum tissues of rabbits to observe the effects of crude extract of P. cocos on motion dynamics of jejunum and cecum of rabbits. [ Result] The addition of crude extract of P. cocos could inhibit the contraction of jejunal and cecal smooth muscle of rabbits in vitro, enhance contraction tension and relaxation tension, and reduce contraction amplitude. The effects were improved as the dose of crude extract of P. cocos increased, displaying a dose-effect relationship. [Condusion] This study provided theoretical basis for the clinical use of P. cocos.展开更多
BACKGROUND Ewing sarcomas(ESs)are highly aggressive malignancy and are predominant in the long bones of extremities of children and young adults with a slight male predilection and rarely presents at extra skeletal lo...BACKGROUND Ewing sarcomas(ESs)are highly aggressive malignancy and are predominant in the long bones of extremities of children and young adults with a slight male predilection and rarely presents at extra skeletal locations.CASE SUMMARY A 55-year-old woman came to our hospital after finding elevated tumor biomarkers during her physical examination.Her enhanced computed tomography scan showed a jejunal mass.The patient underwent laparoscopic enterectomy.The mass was later diagnosed as ES,evidenced by fluorescence in situ hybridization whereby the GLP ES breakpoint region 1 probe was used,showing that more than 10%of the cells showed a red-green-yellow signal proving the breakpoint rearrangement of the ES breakpoint region 1 gene in chromosome 22.CONCLUSION We describe a case of localized ES at the jejunum in China based on the literature.展开更多
Foreign-body ingestion is a relatively common presentation at emergency departments,but long metallic spoon swallowing is an infrequent occurrence.Unlike most cases of foreign-body ingestion,there have been no reporte...Foreign-body ingestion is a relatively common presentation at emergency departments,but long metallic spoon swallowing is an infrequent occurrence.Unlike most cases of foreign-body ingestion,there have been no reported cases of long foreign bodies reaching the jejunum.We report a rare case of a coffee spoon that was swallowed accidentally and passed through the pylorus and duodenal loop and reached the jejunum,with no complications.展开更多
In order to research the absorption and transportation differences ofglutamine containing small peptides and free glutamine in intestine of weaned piglets, 28-day-old weaned piglets were selected to get the sample for...In order to research the absorption and transportation differences ofglutamine containing small peptides and free glutamine in intestine of weaned piglets, 28-day-old weaned piglets were selected to get the sample for jejunum culture in vitro in this study. Trial 1 was conducted to study the stability of tripeptide （Arg-Gly-Gln） in the jejunum to determine the ideal culture time. It was designed into 2 treatments： control group （Kreb＇s solution, GC） and tripeptide group （by adding 556μmol/L of Arg-Gly-Gln to Kreb＇s solution, GP）. They were cultured for 60 min. The absorption and transportation differences ofglutamine existing as Arg-Gly-Gln, Gly-Gln and free Gin were studied in trial 2. It was designed into 4 treatments： group 1 （G1, control group）, Kreb＇s solution; Group 2 （G2）, Kreb＇s solution＋556 μmol/L Arg-Gly-Gln; group 3 （G3）, Kreb＇s solution＋556 μmol/L Gly-Gln and Arg; group 4 （G4）, Kreb＇s solution＋556 μmol/L arginine, glycine and glutamine. They were cultured for 40 minutes. The results indicated that the absorption and transportation of glutamine existing as Arg-Gly-Gln was more efficient than those of Gly-Gln while Gly-Gln was more efficient than free glutamine. Arg-Gly-Gln may be more excellent than Gly-Gln in physiological functions and nutrition potential.展开更多
A diagnosis of intestinal diverticulosis is difficult to make pre-operatively because the clinical symptoms are usually non-specific. We report the case of a 70-year-old man who had suffered from three episodes of int...A diagnosis of intestinal diverticulosis is difficult to make pre-operatively because the clinical symptoms are usually non-specific. We report the case of a 70-year-old man who had suffered from three episodes of intestinal obstruction in 1 year. He experienced dull pain and a sensation of fullness over the whole abdomen. The symptoms did not improve after conservative treatment.The presumptive diagnosis was intestinal obstruction, and an exploratory laparotomy found diverticulosis of the proximal jejunum, with an adhesion band formed from the base of one diverticulum. Strangulation of a segment of the jejunum resulted from the internal herniation caused by the band. The band was removed and the proximal jejunum segmentally resected. His postoperative course was uneventful.展开更多
Primary undifferentiated pleomorphic sarcoma (UPS) of the small intestine is extremely rare. The prognosis of UPS is basically poor, and particular, when accompanied with metastatic lesions. This paper reports the cas...Primary undifferentiated pleomorphic sarcoma (UPS) of the small intestine is extremely rare. The prognosis of UPS is basically poor, and particular, when accompanied with metastatic lesions. This paper reports the case of a long-term survivor of primary UPS of the jejunum with lymph node metastases and a skip lesion in the jejunum. The patient was a 50-year-old Japanese man who presented with a chief complaint of breathlessness. Small bowel X-ray series revealed an approximately 4-cm size with protruded lesion (image shows a filling defect) in the proximal jejunum. Based on a presumptive diagnosis of the hemorrhagic small bowel tumor, he underwent a laparotomy. A tumor was observed in the jejunum at approximately 90-cm from the Treitz ligament;some swollen mesenteric lymph nodules were also observed. Segmental resection of the jejunum was performed 20-140 cm from the Treitz ligament. A complete surgical excision with en-bloc regional lymph node dissection was performed. The final histopathological diagnosis was UPS of the jejunum with metastatic lymph nodes and a skip lesion in the jejunum. The postoperative course was uneventful. The patient was not given adjuvant chemotherapy and was discharged on postoperative day 16. He is currently well without any evidence of recurrence for >10 years after the operation.展开更多
Angiomyolipoma is a benign tumor most commonly arising in the kidney. Very few cases have been reported to be located in the small intestine. Here we report the first case located in the jejunum in a patient who was d...Angiomyolipoma is a benign tumor most commonly arising in the kidney. Very few cases have been reported to be located in the small intestine. Here we report the first case located in the jejunum in a patient who was diagnosed with a colonic adenocarcinoma. In the preoperative evaluation this benign lesion was thought it might represent a metastatic nodule.展开更多
Primary adenocarcinomas of the small bowel are rare. Because of their rarity, non-specific symptoms and diagnostic difficulty, small bowel tumors are often diagnosed and treated late in their course. The diagnostic di...Primary adenocarcinomas of the small bowel are rare. Because of their rarity, non-specific symptoms and diagnostic difficulty, small bowel tumors are often diagnosed and treated late in their course. The diagnostic difficulty is increased when these tumors arise in association with primary synchronous tumors of the colon. We present a case of a 17-year-old female who was evaluated for anemia and bleeding per rectum. Colonoscopy revealed multiple colonic polyps. Intraoperatively, she was surprisingly found to be having a synchronous jejunal growth apart from multiple colonic polyoid lesions. Total colectomy was performed along with resection of jejunal growth. Histopathology of colonic specimen revealed multiple polypoid projections with one polyp showing adenocarcinoma and rest severe dysplasia. Histopathology of jejunal growth revealed poorly-differentiated adenocarcinoma. Very rarely, cases have been reported in literature, where the primary adenocarcinoma of the jejunum developed synchronously with colonic adenocarcinoma, and both treated surgically on the same occasion.展开更多
Single stage reconstruction of circumferential pharyngo-esophageal defects using the free jejunum flap produces excellent functional results with minimal morbidity and mortality. The most serious complication with thi...Single stage reconstruction of circumferential pharyngo-esophageal defects using the free jejunum flap produces excellent functional results with minimal morbidity and mortality. The most serious complication with this flap is vascular compromise, usually within the first 24 - 48 hours after surgery. Compromised flaps are frequently diagnosed late often making their salvage impossible, so close postoperative monitoring of tissue perfusion is critical. Rapid identification and salvage of the failing flap increases the chance of a successful outcome.展开更多
Background Idiopathic hyperoxaluria （IH） may be caused by increased endogenous formation or exogenous absorption of oxalic acid.Characterization of the molecular pathogenesis of IH has been hampered by the lack of a...Background Idiopathic hyperoxaluria （IH） may be caused by increased endogenous formation or exogenous absorption of oxalic acid.Characterization of the molecular pathogenesis of IH has been hampered by the lack of an ideal animal model.We therefore established a stabile rat IH model in order to analyze variation in gene expression profile in the jejunum and to investigate the association between IH pathogenesis and exogenous absorption of oxalic acid.Methods A rat model of IH was established and three female rats with IH were assigned to the study group,while three normal rats served as controls.Total RNA was isolated from the jejunum of rats in the two groups and mRNA was purified,reversely transcribed,labeled with Cy5 or Cy3 and hybridized to 27K Rat Genome Array.Differences in gene expression profile between the 2 groups were analyzed by bioinformatics methods.Results Comparative analysis revealed that the expression of 517 genes was up-regulated and that of 203 genes was down-regulated by at least two-fold in the jejunum of rats with idiopathic hyperoxaluria.These genes are related to many functions including cell signal transduction,DNA binding and transcription,ATP binding,ion binding and transport,cell receptors,immunity,cyclins,cytoskeleton structure,and metabolic proteins.Kyoto encyclopedia of genes and genomes （KEGG） signaling pathway analysis revealed that the variations of 239 pathway functional changes are statistically significant （P 〈0.05）.Conclusions cDNA microarray can be used effectively to screen differentially expressed genes in the jejunum of rats with idiopathic hyperoxaluria. These differentially expressed genes may underlie idiopathic hyperoxaluria pathophysiology and provide a platform for further studying molecular pathogenetic mechanisms.展开更多
This study compared proteome profiles and morphological changes of rat jejunum in response to different dietary proteins. Fifty male Sprague-Dawley rats were fed with casein(control), and isolated beef, pork, fish and...This study compared proteome profiles and morphological changes of rat jejunum in response to different dietary proteins. Fifty male Sprague-Dawley rats were fed with casein(control), and isolated beef, pork, fish and chicken proteins for 14 days. Proteome analysis,histological observation and PEPT1 quantification of the jejunum were performed. The results indicated that rats fed with chicken proteins had higher PEPT1 mRNA and protein levels(P < 0.05) but lower villus height and ratio of villus height to crypt depth(V/C ratio, P < 0.05) than those fed with casein and pork protein. Label-free LC-MS/MS indicated that, as compared to casein, intake of chicken protein can regulate oligopeptide transport mainly by upregulating PEPT1 protein expression and reducing dipeptidyl-peptidase activity related to biological oxidation, and can reduce oligopeptide absorption capacity by regulating Hippo signaling pathway. Although intake of beef and fish proteins had no significant effect on PEPT1 expression, they altered several signaling pathways.展开更多
Background One of the main roles of the intestinal mucosa is to protect against environmental hazards.Supple-mentation of xylo-oligosaccharides(XOS)is known to selectively stimulate the growth of beneficial intestinal...Background One of the main roles of the intestinal mucosa is to protect against environmental hazards.Supple-mentation of xylo-oligosaccharides(XOS)is known to selectively stimulate the growth of beneficial intestinal bacteria and improve gut health and function in chickens.XOS may have an impact on the integrity of the intestinal epithelia where cell turnover is critical to maintain the compatibility between the digestive and barrier functions.The aim of the study was to evaluate the effect of XOS and an arabinoxylan-rich fraction(AXRF)supplementation on gut func-tion and epithelial integrity in broiler chickens.Methods A total of 128 broiler chickens(Ross 308)were assigned into one of two different dietary treatments for a period of 42 d:1)control diet consisting of a corn/soybean meal-based diet;or 2)a control diet supplemented with 0.5%XOS and 1%AXRF.Each treatment was randomly distributed across 8 pens(n=8)with 8 chickens each.Feed intake and body weight were recorded weekly.On d 42,one male chicken per pen was selected based on aver-age weight and euthanized,jejunum samples were collected for proteomics analysis.Results Dietary XOS/AXRF supplementation improved feed efficiency(P<0.05)from d 1 to 42 compared to the con-trol group.Proteomic analysis was used to understand the mechanism of improved efficiency uncovering 346 dif-ferentially abundant proteins(DAP)(Padj<0.00001)in supplemented chickens compared to the non-supplemented group.In the jejunum,the DAP translated into decreased ATP production indicating lower energy expenditure by the tissue(e.g.,inhibition of glycolysis and tricarboxylic acid cycle pathways).In addition,DAP were associated with decreased epithelial cell differentiation,and migration by reducing the actin polymerization pathway.Put-ting the two main pathways together,XOS/AXRF supplementation may decrease around 19%the energy required for the maintenance of the gastrointestinal tract.Conclusions Dietary XOS/AXRF supplementation improved growth efficiency by reducing epithelial cell migration and differentiation(hence,turnover),actin polymerization,and consequently energy requirement for maintenance of the jejunum of broiler chickens.展开更多
BACKGROUND Obesity is associated with a significantly increased risk for chronic diarrhea,which has been proposed as Linghu’s obesity-diarrhea syndrome(ODS);however,its molecular mechanisms are largely unknown.AIM To...BACKGROUND Obesity is associated with a significantly increased risk for chronic diarrhea,which has been proposed as Linghu’s obesity-diarrhea syndrome(ODS);however,its molecular mechanisms are largely unknown.AIM To reveal the transcriptomic changes in the jejunum involved in ODS.METHODS In a cohort of 6 ODS patients(JOD group),6 obese people without diarrhea(JO group),and 6 healthy controls(JC group),high-throughput sequencing and bioinformatics analyses were performed to identify jejunal mucosal mRNA expression alterations and dysfunctional biological processes.In another cohort of 16 ODS patients(SOD group),16 obese people without diarrhea(SO group),and 16 healthy controls(SC group),serum diamine oxidase(DAO)and D-lactate(DLA)concentrations were detected to assess changes in intestinal barrier function.RESULTS The gene expression profiles of jejunal mucosa in the JO and JC groups were similar,with only 1 differentially expressed gene(DEG).The gene expression profile of the JOD group was significantly changed,with 411 DEGs compared with the JO group and 211 DEGs compared with the JC group,129 of which overlapped.The enrichment analysis of these DEGs showed that the biological processes such as digestion,absorption,and transport of nutrients(especially lipids)tended to be up-regulated in the JOD group,while the biological processes such as rRNA processing,mitochondrial translation,antimicrobial humoral response,DNA replication,and DNA repair tended to be down-regulated in the JOD group.Eight DEGs(CDT1,NHP2,EXOSC5,EPN3,NME1,REG3A,PLA2G2A,and PRSS2)may play a key regulatory role in the pathological process of ODS,and their expression levels were significantly decreased in ODS patients(P<0.001).In the second cohort,compared with healthy controls,the levels of serum intestinal barrier function markers(DAO and D-LA)were significantly increased in all obese individuals(P<0.01),but were higher in the SOD group than in the SO group(P<0.001).CONCLUSION Compared with healthy controls and obese individuals without diarrhea,patients with Linghu’s ODS had extensive transcriptomic changes in the jejunal mucosa,likely affecting intestinal barrier function and thus contributing to the obesity and chronic diarrhea phenotypes.展开更多
BACKGROUND Cystic lymphangioma is a rare benign tumor that affects the lymphatic system.Mesenteric lymphangiomas in the small bowel are extremely uncommon.CASE SUMMARY We present a 21-year-old female patient who compl...BACKGROUND Cystic lymphangioma is a rare benign tumor that affects the lymphatic system.Mesenteric lymphangiomas in the small bowel are extremely uncommon.CASE SUMMARY We present a 21-year-old female patient who complained of abdominal pain.The diagnosis of ovarian torsion was suspected after abdominopelvic unenhanced computed tomography and ultrasound revealed a large cyst in contact with the bladder,ovary,and uterus.The patient underwent emergency laparotomy per-formed by gynecologists,but it was discovered that the cystic tumor originated from the jejunum.Gastrointestinal surgeons were then called in to perform a cystectomy.Pathological examination confirmed the diagnosis of cystic lymphangioma of the mesentery.The patient had an uneventful postoperative recovery.CONCLUSION Mesenteric lymphangiomas can cause abdominal pain,and imaging techniques can help determine their characteristics,location,and size.Complete surgical excision and pathological examination are considered the standard treatment and diagnostic method.展开更多
文摘Accidentally swallowed foreign objects are not uncommon but difficult to manage without complications. We describe the case of a 68 year old man who accidentally a swallowed sharp-pointed dental reamer that had reached deep in his jejunum. Double balloon enteroscopic retrieval was performed with polypectomy snare but the reamer was entangled in the wire loop of the snare and penetrated the jejunal wall. After releasing the reamer by pushing and pulling the snare for approximately 30 min, the reamer was retrieved with biopsy forceps. This is the first report of double balloon enteroscopic removal of a dental reamer. Furthermore, this is a novel case with regard to decision making in situations when sharp objects are swallowed.
基金Natural Science Foudation of Hebei ProvinceEducation Department Foundation of Hebei Province.No.2002136.
文摘AIM: To study the distribution of the constitutive nitric oxide synthase (NOS) in the jejunum of adult rat. METHODS: The distribution of endothelial NOS (eNOS) was detected by immunohistochemistry. Immunofluorescence histochemical dual staining technique were used for studying the distribution of neuronal NOS (nNOS) and eNOS. The dual stained slides were observed under a confocal laser scanning microscope. RESULTS: Positive neuronal NOS (nNOS) and endothelial NOS (eNOS) cells were found to be distributed in lamina propria of villi, and the epithelial cell was not stained. eNOS was mainly located in submucosal vascular endothelia, while nNOS was mainly situated in myenteric plexus. Some cells in the villi had both nNOS and eNOS. More than 80% of the cells were positive for both nNOS and eNOS, the rest cells were positive either for nNOS or for eNOS. CONCLUSION: The two constitutive nitric oxide synthases are distributed differently in the jejunum of rat. nNOS distributed in myenteric plexus is a neurotransmitter in the non-adrenergic non-cholinergic (NANC) inhibitory nerves. eNOS distributed in endothelial and smooth muscle cells of blood vessels plays vasodilator role. eNOS and nNOS are coexpressed in some cells of lamina propria of villi. NO generated by those NOS is very important in the physiological and pathological process of small intestine.
基金Supported by Key Program for Science and Technology Research from the Education Department of Henan Province(13B230336)
文摘[ Objective] This study aimed to investigate the effects of crude extract of Poria cocos on intestinal smooth muscle contraction of rabbits in vitro and re- veal the related mechanism. [Method] With in vitro experimental method, using the tension of jejunal and cecal smooth muscle as an indicator, 3.75, 7.50, 15.00, and 22.5 g/L crude extract of P. cocos were added into Tyrede＇s solution of jejunum and cecum tissues of rabbits to observe the effects of crude extract of P. cocos on motion dynamics of jejunum and cecum of rabbits. [ Result] The addition of crude extract of P. cocos could inhibit the contraction of jejunal and cecal smooth muscle of rabbits in vitro, enhance contraction tension and relaxation tension, and reduce contraction amplitude. The effects were improved as the dose of crude extract of P. cocos increased, displaying a dose-effect relationship. [Condusion] This study provided theoretical basis for the clinical use of P. cocos.
文摘BACKGROUND Ewing sarcomas(ESs)are highly aggressive malignancy and are predominant in the long bones of extremities of children and young adults with a slight male predilection and rarely presents at extra skeletal locations.CASE SUMMARY A 55-year-old woman came to our hospital after finding elevated tumor biomarkers during her physical examination.Her enhanced computed tomography scan showed a jejunal mass.The patient underwent laparoscopic enterectomy.The mass was later diagnosed as ES,evidenced by fluorescence in situ hybridization whereby the GLP ES breakpoint region 1 probe was used,showing that more than 10%of the cells showed a red-green-yellow signal proving the breakpoint rearrangement of the ES breakpoint region 1 gene in chromosome 22.CONCLUSION We describe a case of localized ES at the jejunum in China based on the literature.
文摘Foreign-body ingestion is a relatively common presentation at emergency departments,but long metallic spoon swallowing is an infrequent occurrence.Unlike most cases of foreign-body ingestion,there have been no reported cases of long foreign bodies reaching the jejunum.We report a rare case of a coffee spoon that was swallowed accidentally and passed through the pylorus and duodenal loop and reached the jejunum,with no complications.
文摘In order to research the absorption and transportation differences ofglutamine containing small peptides and free glutamine in intestine of weaned piglets, 28-day-old weaned piglets were selected to get the sample for jejunum culture in vitro in this study. Trial 1 was conducted to study the stability of tripeptide （Arg-Gly-Gln） in the jejunum to determine the ideal culture time. It was designed into 2 treatments： control group （Kreb＇s solution, GC） and tripeptide group （by adding 556μmol/L of Arg-Gly-Gln to Kreb＇s solution, GP）. They were cultured for 60 min. The absorption and transportation differences ofglutamine existing as Arg-Gly-Gln, Gly-Gln and free Gin were studied in trial 2. It was designed into 4 treatments： group 1 （G1, control group）, Kreb＇s solution; Group 2 （G2）, Kreb＇s solution＋556 μmol/L Arg-Gly-Gln; group 3 （G3）, Kreb＇s solution＋556 μmol/L Gly-Gln and Arg; group 4 （G4）, Kreb＇s solution＋556 μmol/L arginine, glycine and glutamine. They were cultured for 40 minutes. The results indicated that the absorption and transportation of glutamine existing as Arg-Gly-Gln was more efficient than those of Gly-Gln while Gly-Gln was more efficient than free glutamine. Arg-Gly-Gln may be more excellent than Gly-Gln in physiological functions and nutrition potential.
文摘A diagnosis of intestinal diverticulosis is difficult to make pre-operatively because the clinical symptoms are usually non-specific. We report the case of a 70-year-old man who had suffered from three episodes of intestinal obstruction in 1 year. He experienced dull pain and a sensation of fullness over the whole abdomen. The symptoms did not improve after conservative treatment.The presumptive diagnosis was intestinal obstruction, and an exploratory laparotomy found diverticulosis of the proximal jejunum, with an adhesion band formed from the base of one diverticulum. Strangulation of a segment of the jejunum resulted from the internal herniation caused by the band. The band was removed and the proximal jejunum segmentally resected. His postoperative course was uneventful.
文摘Primary undifferentiated pleomorphic sarcoma (UPS) of the small intestine is extremely rare. The prognosis of UPS is basically poor, and particular, when accompanied with metastatic lesions. This paper reports the case of a long-term survivor of primary UPS of the jejunum with lymph node metastases and a skip lesion in the jejunum. The patient was a 50-year-old Japanese man who presented with a chief complaint of breathlessness. Small bowel X-ray series revealed an approximately 4-cm size with protruded lesion (image shows a filling defect) in the proximal jejunum. Based on a presumptive diagnosis of the hemorrhagic small bowel tumor, he underwent a laparotomy. A tumor was observed in the jejunum at approximately 90-cm from the Treitz ligament;some swollen mesenteric lymph nodules were also observed. Segmental resection of the jejunum was performed 20-140 cm from the Treitz ligament. A complete surgical excision with en-bloc regional lymph node dissection was performed. The final histopathological diagnosis was UPS of the jejunum with metastatic lymph nodes and a skip lesion in the jejunum. The postoperative course was uneventful. The patient was not given adjuvant chemotherapy and was discharged on postoperative day 16. He is currently well without any evidence of recurrence for >10 years after the operation.
文摘Angiomyolipoma is a benign tumor most commonly arising in the kidney. Very few cases have been reported to be located in the small intestine. Here we report the first case located in the jejunum in a patient who was diagnosed with a colonic adenocarcinoma. In the preoperative evaluation this benign lesion was thought it might represent a metastatic nodule.
文摘Primary adenocarcinomas of the small bowel are rare. Because of their rarity, non-specific symptoms and diagnostic difficulty, small bowel tumors are often diagnosed and treated late in their course. The diagnostic difficulty is increased when these tumors arise in association with primary synchronous tumors of the colon. We present a case of a 17-year-old female who was evaluated for anemia and bleeding per rectum. Colonoscopy revealed multiple colonic polyps. Intraoperatively, she was surprisingly found to be having a synchronous jejunal growth apart from multiple colonic polyoid lesions. Total colectomy was performed along with resection of jejunal growth. Histopathology of colonic specimen revealed multiple polypoid projections with one polyp showing adenocarcinoma and rest severe dysplasia. Histopathology of jejunal growth revealed poorly-differentiated adenocarcinoma. Very rarely, cases have been reported in literature, where the primary adenocarcinoma of the jejunum developed synchronously with colonic adenocarcinoma, and both treated surgically on the same occasion.
文摘Single stage reconstruction of circumferential pharyngo-esophageal defects using the free jejunum flap produces excellent functional results with minimal morbidity and mortality. The most serious complication with this flap is vascular compromise, usually within the first 24 - 48 hours after surgery. Compromised flaps are frequently diagnosed late often making their salvage impossible, so close postoperative monitoring of tissue perfusion is critical. Rapid identification and salvage of the failing flap increases the chance of a successful outcome.
文摘Background Idiopathic hyperoxaluria （IH） may be caused by increased endogenous formation or exogenous absorption of oxalic acid.Characterization of the molecular pathogenesis of IH has been hampered by the lack of an ideal animal model.We therefore established a stabile rat IH model in order to analyze variation in gene expression profile in the jejunum and to investigate the association between IH pathogenesis and exogenous absorption of oxalic acid.Methods A rat model of IH was established and three female rats with IH were assigned to the study group,while three normal rats served as controls.Total RNA was isolated from the jejunum of rats in the two groups and mRNA was purified,reversely transcribed,labeled with Cy5 or Cy3 and hybridized to 27K Rat Genome Array.Differences in gene expression profile between the 2 groups were analyzed by bioinformatics methods.Results Comparative analysis revealed that the expression of 517 genes was up-regulated and that of 203 genes was down-regulated by at least two-fold in the jejunum of rats with idiopathic hyperoxaluria.These genes are related to many functions including cell signal transduction,DNA binding and transcription,ATP binding,ion binding and transport,cell receptors,immunity,cyclins,cytoskeleton structure,and metabolic proteins.Kyoto encyclopedia of genes and genomes （KEGG） signaling pathway analysis revealed that the variations of 239 pathway functional changes are statistically significant （P 〈0.05）.Conclusions cDNA microarray can be used effectively to screen differentially expressed genes in the jejunum of rats with idiopathic hyperoxaluria. These differentially expressed genes may underlie idiopathic hyperoxaluria pathophysiology and provide a platform for further studying molecular pathogenetic mechanisms.
基金supported by the National Natural Science Foundation of China (31471600, 31530054)
文摘This study compared proteome profiles and morphological changes of rat jejunum in response to different dietary proteins. Fifty male Sprague-Dawley rats were fed with casein(control), and isolated beef, pork, fish and chicken proteins for 14 days. Proteome analysis,histological observation and PEPT1 quantification of the jejunum were performed. The results indicated that rats fed with chicken proteins had higher PEPT1 mRNA and protein levels(P < 0.05) but lower villus height and ratio of villus height to crypt depth(V/C ratio, P < 0.05) than those fed with casein and pork protein. Label-free LC-MS/MS indicated that, as compared to casein, intake of chicken protein can regulate oligopeptide transport mainly by upregulating PEPT1 protein expression and reducing dipeptidyl-peptidase activity related to biological oxidation, and can reduce oligopeptide absorption capacity by regulating Hippo signaling pathway. Although intake of beef and fish proteins had no significant effect on PEPT1 expression, they altered several signaling pathways.
文摘Background One of the main roles of the intestinal mucosa is to protect against environmental hazards.Supple-mentation of xylo-oligosaccharides(XOS)is known to selectively stimulate the growth of beneficial intestinal bacteria and improve gut health and function in chickens.XOS may have an impact on the integrity of the intestinal epithelia where cell turnover is critical to maintain the compatibility between the digestive and barrier functions.The aim of the study was to evaluate the effect of XOS and an arabinoxylan-rich fraction(AXRF)supplementation on gut func-tion and epithelial integrity in broiler chickens.Methods A total of 128 broiler chickens(Ross 308)were assigned into one of two different dietary treatments for a period of 42 d:1)control diet consisting of a corn/soybean meal-based diet;or 2)a control diet supplemented with 0.5%XOS and 1%AXRF.Each treatment was randomly distributed across 8 pens(n=8)with 8 chickens each.Feed intake and body weight were recorded weekly.On d 42,one male chicken per pen was selected based on aver-age weight and euthanized,jejunum samples were collected for proteomics analysis.Results Dietary XOS/AXRF supplementation improved feed efficiency(P<0.05)from d 1 to 42 compared to the con-trol group.Proteomic analysis was used to understand the mechanism of improved efficiency uncovering 346 dif-ferentially abundant proteins(DAP)(Padj<0.00001)in supplemented chickens compared to the non-supplemented group.In the jejunum,the DAP translated into decreased ATP production indicating lower energy expenditure by the tissue(e.g.,inhibition of glycolysis and tricarboxylic acid cycle pathways).In addition,DAP were associated with decreased epithelial cell differentiation,and migration by reducing the actin polymerization pathway.Put-ting the two main pathways together,XOS/AXRF supplementation may decrease around 19%the energy required for the maintenance of the gastrointestinal tract.Conclusions Dietary XOS/AXRF supplementation improved growth efficiency by reducing epithelial cell migration and differentiation(hence,turnover),actin polymerization,and consequently energy requirement for maintenance of the jejunum of broiler chickens.
文摘BACKGROUND Obesity is associated with a significantly increased risk for chronic diarrhea,which has been proposed as Linghu’s obesity-diarrhea syndrome(ODS);however,its molecular mechanisms are largely unknown.AIM To reveal the transcriptomic changes in the jejunum involved in ODS.METHODS In a cohort of 6 ODS patients(JOD group),6 obese people without diarrhea(JO group),and 6 healthy controls(JC group),high-throughput sequencing and bioinformatics analyses were performed to identify jejunal mucosal mRNA expression alterations and dysfunctional biological processes.In another cohort of 16 ODS patients(SOD group),16 obese people without diarrhea(SO group),and 16 healthy controls(SC group),serum diamine oxidase(DAO)and D-lactate(DLA)concentrations were detected to assess changes in intestinal barrier function.RESULTS The gene expression profiles of jejunal mucosa in the JO and JC groups were similar,with only 1 differentially expressed gene(DEG).The gene expression profile of the JOD group was significantly changed,with 411 DEGs compared with the JO group and 211 DEGs compared with the JC group,129 of which overlapped.The enrichment analysis of these DEGs showed that the biological processes such as digestion,absorption,and transport of nutrients(especially lipids)tended to be up-regulated in the JOD group,while the biological processes such as rRNA processing,mitochondrial translation,antimicrobial humoral response,DNA replication,and DNA repair tended to be down-regulated in the JOD group.Eight DEGs(CDT1,NHP2,EXOSC5,EPN3,NME1,REG3A,PLA2G2A,and PRSS2)may play a key regulatory role in the pathological process of ODS,and their expression levels were significantly decreased in ODS patients(P<0.001).In the second cohort,compared with healthy controls,the levels of serum intestinal barrier function markers(DAO and D-LA)were significantly increased in all obese individuals(P<0.01),but were higher in the SOD group than in the SO group(P<0.001).CONCLUSION Compared with healthy controls and obese individuals without diarrhea,patients with Linghu’s ODS had extensive transcriptomic changes in the jejunal mucosa,likely affecting intestinal barrier function and thus contributing to the obesity and chronic diarrhea phenotypes.
文摘BACKGROUND Cystic lymphangioma is a rare benign tumor that affects the lymphatic system.Mesenteric lymphangiomas in the small bowel are extremely uncommon.CASE SUMMARY We present a 21-year-old female patient who complained of abdominal pain.The diagnosis of ovarian torsion was suspected after abdominopelvic unenhanced computed tomography and ultrasound revealed a large cyst in contact with the bladder,ovary,and uterus.The patient underwent emergency laparotomy per-formed by gynecologists,but it was discovered that the cystic tumor originated from the jejunum.Gastrointestinal surgeons were then called in to perform a cystectomy.Pathological examination confirmed the diagnosis of cystic lymphangioma of the mesentery.The patient had an uneventful postoperative recovery.CONCLUSION Mesenteric lymphangiomas can cause abdominal pain,and imaging techniques can help determine their characteristics,location,and size.Complete surgical excision and pathological examination are considered the standard treatment and diagnostic method.
