Typical gastroduodenal endoscopic findings in a Crohn's disease patient in remission stage

A 39-year-old patient with Crohn's disease (CD) was referred to our hospital for maintenance treatment of CD.He was diagnosed as having CD of the small and large intestines at 32 years old.He underwent partial resection of the ileum at 35 years old because of ileal perforation.He had received enteral nutritional supplement (1200 kcal/d) and metronidazole preparation (500 mg/d),and was in remission Crohn's disease activity index 73.We performed a routine gastroduodenal endoscopic examination,which revealed the representative endoscopic findings of gastroduodenal lesions in CD,namely,bamboo-joint-like appearance of the gastric body and cardia and a notched sign in the duodenum.These findings were clearly observed by using indigo carmine dye spraying.In our patient,typical gastroduodenal findings were observed even in the remission stage,suggesting that these findings would contribute to the early diagnosis of CD not only in the active stage but also during remission.

Terry's nail: an overlooked physical finding incirrhosis

The Editor welcomes submissions for possible publication in the Letters to the Editor section.Letters commenting on an article published in the Journal or other interesting pieces will be considered if they are received within 6 weeks of the time the article was published.

Incidental findings at MRI-enterography in patients with suspected or known Crohn's disease

AIM:To determine the frequency and clinical impact of incidental findings detected with magnetic resonance imaging(MRI)-enterography in patients with suspected or known Crohn's disease(CD). METHODS:Incidental findings were defined as unexpected lesions outside the small intestine,not previously known or suspected at the time of referral, and not related to inflammatory bowel disease.Through a systematic review of medical charts we analyzed the clinical impact of incidental findings,and compared the MRI findings with subsequent diagnostic procedures. RESULTS:A total of 283 patients were included in the analysis,and MRI detected active CD in 31%,fistula in 1.4%and abscess in 0.7%.Extra-intestinal findings notrelated to CD were recorded in 72 patients(25%),of which 58 patients(20%)had 74 previously unknown lesions.Important or incompletely characterized findings were detected in 17 patients(6.0%).Incidental findings led to 12 further interventions in 9 patients(3.2%) revealing previously unknown pathological conditions in 5(1.8%).One patient(0.4%)underwent surgery and one patient was diagnosed with a malignant disease. MRI detected incidental colonic lesions in 16 patients of which additional work-up in 4 revealed normal anatomy. Two patients(0.7%)benefitted from the additional examinations,whereas incidental findings led to unnecessary examinations in 9(3.2%). CONCLUSION:In a minority of patients with suspected or known CD,important incidental findings are diagnosed at MRI-enterography.However,a substantial number of patients experience unnecessary morbidity because of additional examinations of benign or normal conditions.

Comment on "Terry's nail: an overlooked physical finding in cirrhosis"

To the Editor:We read with great interest the recent paper by Baran and colleagues,[1]published in the journal of Hepatobiliary Pancreatic Diseases International.The authors presented nails abnormalities in a 65-year-old woman with cryptogenic cirrhosis and hepatocellular carcinoma and described them as Terry’s nails.Whether they were Terry’s nails remains controversial,at least far away from

A Bulletinon Survey Findings of China's National Population and Reproductive Health in 1997

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Causality between bank’s major activities and economic growth:evidences from Pakistan

Background:Banking is an important sector of Pakistan’s economy.It is general consideration that bank’s major activities saving and lending have positive impact on economic growth.So the aim of this study is to investigate this consideration and also investigate that either growth led deposits and credits,or deposit and credits led growth means the purpose of this study is to investigate the direction of this relationship.Methods:Johansen test of Co-integration and Granger Causality is employed by using time series data of Pakistan from 1961 to 2013.Results:The results show that two major activities of banking sector that are saving and lending don’t have any long run or short run causality towards economic growth so the general consideration of positive impact of these activities proved wrong in case of Pakistan.However there is unidirectional causality running from GDP growth to credit provided by banking sector which shows that economic prosperity or economic growth will have a major impact on lending activities of banks meaning that demand following hypothesis is true for Pakistan in case of GDP and Bank’s credit or we can say that growth led Bank’s credit in Pakistan.Conclusions:Hence Government and central bank should make policies by keeping this fact in consideration that bank’s two major activities that are saving and lending does not have impact on GDP growth.There might be other factors which influence economic growth of Pakistan more than banking sector these activities,which can be bank’s profitability,human resource,technology,infrastructure and other sectors of the economy.However GDP growth affects bank’s lending activities so during high economic growth year central bank and private bank’s management should introduce easy loans for businesses and industries and during poor economic growth years personal loan’s new schemes should be introduce by banks.

The Quiet Life Finding a peaceful oasis among China’s watertowns

One of the more pleasurable aspects of living in China is the choice of travel options in a country with topographies that range from desert to mountains and snow drifts to water towns.One of the less tourist populated water towns is the sleepy hollow of Nanxun,a few hours bus ride from Shanghai.

Analysis of cranial aneurysm's 3D-computational hemodynamics numerical simulation and findings in operation

Objective With the cranial aneurysm’s 3D-computational hemodynamics numerical simulation,we can get the cranial aneurysms and its ’s mother arteries ’blood flow rate,path and wall shearing stress and so on. Taking use of the contrast analysis of the hemodynamics result and the findings in operation,we try to find hemodynamic character and mechanism of rupture

Therapeutic roles of plants for 15 hypothesised causal bases of Alzheimer’s disease

Alzheimer’s disease(AD)is progressive and ultimately fatal,with current drugs failing to reverse and cure it.This study aimed to find plant species which may provide therapeutic bioactivities targeted to causal agents proposed to be driving AD.A novel toolkit methodology was employed,whereby clinical symptoms were translated into categories recognized in ethnomedicine.These categories were applied to find plant species with therapeutic effects,mined from ethnomedical surveys.Survey locations were mapped to assess how this data is at risk.Bioactivities were found of therapeutic relevance to 15 hypothesised causal bases for AD.107 species with an ethnological report of memory improvement demonstrated therapeutic activity for all these 15 causal bases.The majority of the surveys were found to reside within biodiversity hotspots(centres of high biodiversity under threat),with loss of traditional knowledge the most common threat.Our findings suggest that the documented plants provide a large resource of AD thera-peutic potential.In demonstrating bioactivities targeted to these causal bases,such plants may have the capacity to reduce or reverse AD,with promise as drug leads to target multiple AD hallmarks.However,there is a need to preserve ethnomedical knowledge,and the habitats on which this knowledge depends.

Causalities between Price, Pond Area and Employment in Aquaculture Production

The role of aquaculture industry is becoming more prominent in order to supplement marine capture in meeting the food need for the growing Malaysian population. In an attempt to minimize depletion of marine fisheries, only traditional vessels are allowed to fish along the coastal area while bigger vessels are relegated to deep-sea fishing. During the 9th Malaysian Plan (2006-2010) aquaculture has been recognized as the engine of growth in the national food sector’s development strategy. Future fisheries policy is expected to focus more on aquaculture production, marketing and technological improvement as an alternative to marine capture. This paper investigates the causalities between the selected freshwater fish prices, aquaculture area and production. The study aspires to establish whether or not market price is a key contributor to a rise in the aquaculture area and production. Aquaculture firms comprising the individual culturists are generally motivated by the economic potential of the industry which is reflected in excess of price over cost of production. Our hypothesis is that government policy and initiation rather than prices had give rise to greater participation of culturists and hence augmented the level of employment. However, production increase has a negative implication on environment degradation. Thus there is a conflicting view as regards to the employment opportunity generated by aquaculture undertakings and the need for sustainable development arising from this growing industry. Multivariate time series analysis was used in this investigation.

高速互连PCB的材料电磁表征方法研究

随着数据传输速率的不断增加,对高速互连的信号完整性设计和优化变得至关重要。在高速通道设计的各个方面中,我们通过对现有的方法进行综述来着重介绍准确的PCB材料电磁表征这一关键问题,并对于提取PCB材料特性,如介电常数、损耗正切以及铜表面粗糙度的各种方法进行分类。首先,这些方法分为两大类:①对原始介质材料进行表征的技术;②适用于一般由玻璃纤维和树脂材料混合而成的PCB材料的表征方法。在每个类别中,简要描述了几种常用技术,并进行了优缺点的比较和讨论。基于传输线的方法的挑战和局限性在这里尤为重要,因为相关的材料特性提取程序在工业中已经是常规操作。此外,特别是在数十吉赫兹的频率范围内,典型铜箔表面粗糙度对准确材料表征的影响也被考虑。本文旨在通过总结和比较提供PCB材料表征方法的全面概述和分析。

海底管道S-Lay铺设过程中的质量控制

海底管道作为最主要的海洋石油天然气的运输方式,对施工质量要求很高。在对S-Lay铺管船铺设海底管道的铺管工艺进行介绍的基础上,利用因果分析法,对铺管过程中的潜在风险因素进行了识别和分析,并针对这些问题,对铺管过程中各个环节的质量控制要点进行了阐述,对类似项目的质量管理有参考意义。

中国相对价格水平变动的B-S效应机理分析

供给是导致通货膨胀的因素之一。对于快速增长的发展中经济体,巴拉萨-萨缪尔森效应(B-S效应)是从供给角度解释其相对价格上涨的基础理论。针对中国新一轮物价上涨趋势,首先从理论上探讨了B-S效应对中国的适用性,并以1982年—2009年期间中美两国相关数据为样本,运用格兰杰因果检验方法对B-S效应在中国的适用性进行了实证检验,结果显示中国B-S效应成立。

T-S模糊门在因果图中的应用

T-S模糊门在故障树分析中已得到广泛应用,并具有较好的实用性.鉴于因果图和故障树都可以用于故障诊断,用图形表示因果关系,两者具有很多相似性,并且在一定条件下,因果图和故障树可以相互转化,故将T-S模糊门引入到因果图中,考察其实用价值.

Small intestine contrast ultrasonography vs computed tomography enteroclysis for assessing ileal Crohn's disease

AIM:To compare computed tomography enteroclysis(CTE) vs small intestine contrast ultrasonography(SICUS) for assessing small bowel lesions in Crohn's disease(CD),when using surgical pathology as gold standard.METHODS:From January 2007 to July 2008,15 eligible patients undergoing elective resection of the distal ileum and coecum(or right colon) were prospectively enrolled.All patients were under follow-up.The study population included 6 males and 9 females,with a median age of 44 years(range:18-80 years).Inclusion criteria:(1) certain diagnosis of small bowel requiring elective ileo-colonic resection;(2) age between 18-80 years;(3) elective surgery in our Surgical Unit;and(4) written informed consent.SICUS and CTE were performed ≤ 3 mo before surgery,followed by surgical pathology.The following small bowel lesions were blindly reported by one sonologist,radiologist,surgeon and histolopathologist:disease site,extent,strictures,abscesses,fistulae,small bowel dilation.Comparison between findings at SICUS,CTE,surgical specimens and histological examination was made by assessing the specificity,sensitivity and accuracy of each technique,when using surgical findings as gold standard.RESULTS:Among the 15 patients enrolled,CTE was not feasible in 2 patients,due to urgent surgery in one patients and to low compliance in the second patient,refusing to perform CTE due to the discomfort related to the naso-jejunal tube.The analysis for comparing CTE vs SICUS findings was therefore performed in 13 out of the 15 CD patients enrolled.Differently from CTE,SICUS was feasible in all the 15 patients enrolled.No complications were observed when using SICUS or CTE.Surgical pathology findings in the tested population included:small bowel stricture in 13 patients,small bowel dilation above ileal stricture in 10 patients,abdominal abscesses in 2 patients,enteric fistulae in 5 patients,lymphnodes enlargement(> 1 cm) in 7 patients and mesenteric enlargement in 9 patients.In order to compare findings by using SICUS,CTE,histology and surgery,characteristics of the small bowel lesions observed in CD each patient were blindly reported in the same form by one gastroenterologistsonologist,radiologist,surgeon and anatomopathologist.At surgery,lesions related to CD were detected in the distal ileum in all 13 patients,also visualized by both SICUS and CTE in all 13 patients.Ileal lesions > 10 cm length were detected at surgery in all the 13 CD patients,confirmed by SICUS and CTE in the same 12 out of the 13 patients.When using surgical findings as a gold standard,SICUS and CTE showed the exactly same sensitivity,specificity and accuracy for detecting the presence of small bowel fistulae(accuracy 77% for both) and abscesses(accuracy 85% for both).In the tested CD population,SICUS and CTE were also quite comparable in terms of accuracy for detecting the presence of small bowel strictures(92% vs 100%),small bowel fistulae(77% for both) and small bowel dilation(85% vs 82%).CONCLUSION:In our study population,CTE and the non-invasive and radiation-free SICUS showed a comparable high accuracy for assessing small bowel lesions in CD.

H pylori infection in patients with Behcet's disease

AIM:To evaluate endoscopic findings and the prevalence of H pylori in patients with Behcet's disease (BD) who have upper gastrointestinal symptoms. METHODS:The patients with BD diagnosed according to the International Study Group and followed up in the Department of Dermatology and other related departments and who had any upper gastrointestinal complaints,were included in this study. Forty-five patients with BD and 40 patients in the control group were evaluated by upper gastrointestinal endoscopy and two biopsied specimens were taken during endoscopy for H pylori . A two-week triple therapy for H pylori eradication was administered to H pylori positive patients. Two months after the treatment,the patients were evaluated by urea-breath test for eradication control. RESULTS:Patients with BD had a mean age of 36.2 ± 11.4 years (18-67 years). The mean follow-up time was 35 ± 14 mo (16-84 mo). Aphthous or deep ulcer in esophagus,stomach and duodenum had never been confirmed by endoscopic examination. Most gastric lesions were gastric erosion (40%) and the most duodenal lesions were duodenitis (17.5%) in two groups. H pylori was positive in 33 patients (73.3%) with BD. The two-week triple eradication therapy was successful in 75% of the patients. There was no difference between the groups in respect to prevalence of H pylori (73.3% vs 75%,P > 0.05),and eradication rate (75% vs 70%,P > 0.05). CONCLUSION:Endoscopic findings,eradication rate and prevalence of H pylori were similar in patients withBD and control group.

The relationship between international crude oil prices and China＇s refined oil prices based on a structural VAR model

With the frequent fluctuations of international crude oil prices and China＇s increasing dependence on foreign oil in recent years, the volatility of international oil prices has significantly influenced China domestic refined oil price. This paper aims to investigate the transmission and feedback mechanism between international crude oil prices and China＇s refined oil prices for the time span from January 2011 to November 2015 by using the Granger causality test, vector autoregression model, impulse response function and variance decomposition methods. It is demonstrated that variation of international crude oil prices can cause China domestic refined oil price to change with a weak feedback effect. Moreover, international crude oil prices and China domestic refined oil prices are affected by their lag terms in positive and negative directions in different degrees. Besides, an international crude oil price shock has a signif- icant positive impact on domestic refined oil prices while the impulse response of the international crude oil price variable to the domestic refined oil price shock is negatively insignificant. Furthermore, international crude oil prices and domestic refined oil prices have strong historical inheri- tance. According to the variance decomposition analysis, the international crude oil price is significantly affected by its own disturbance influence, and a domestic refined oil price shock has a slight impact on international crude oil price changes. The domestic refined oil price variance is mainly caused by international crude oil price disturbance, while the domestic refined oil price is slightly affected by its own disturbance. Generally, domestic refined oil prices do not immediately respond to an international crude oil price change, that is, there is a time lag.

Comparative analysis of various modularization algorithms and species specific study of VEGF signaling pathways

In biology, signal transduction refers to a process by which a cell converts one kind of signal or stimulus into another. It involves ordered sequences of biochemical reactions inside the cell. These cascades of reactions are carried out by enzymes and activated by second messengers. Signal transduction pathways are complex in nature. Each pathway is responsible for tuning one or more biological functions in the intracellular environment as well as more than one pathway interact among themselves to carry forward a single biological function. Such kind of behavior of these pathways makes understanding difficult. Hence, for the sake of simplicity, they need to be partitioned into smaller modules and then analyzed. We took VEGF signaling pathway, which is responsible for angiogenesis for this kind of modularized study. Modules were obtained by applying the algorithm of Nayak and De (Nayak and De, 2007) for different complexity values. These sets of modules were compared among themselves to get the best set of modules for an optimal complexity value. The best set of modules compared with four different partitioning algorithms namely, Farhat’s (Farhat, 1998), Greedy (Chartrand and Oellermann, 1993), Kernighan-Lin’s (Kernighan and Lin, 1970) and Newman’s community finding algorithm (Newman, 2006). These comparisons enabled us to decide which of the aforementioned algorithms was the best one to create partitions from human VEGF signaling pathway. The optimal complexity value, on which the best set of modules was obtained, was used to get modules from different species for comparative study. Comparison among these modules would shed light on the trend of development of VEGF signaling pathway over these species.

基于超椭球模型的T-S模糊因果图的故障分析

研究了用区间数对T-S模糊因果图的故障诊断问题,同时考虑了基于超椭球模型对因果图的故障区间加以约束;首先,建立T-S模糊门,通过D-S理论建立适当的超椭球模型处理因果图中不确定性参量的取值范围和解决复杂系统的故障机理和多态性;其次,将超椭球模型转化成单位超椭球模型,在超椭球内产生均匀分布的随机数,对其进行均匀采样,从而得到了更加符合实际T-S规则的故障可能性区间概率;最后,利用Matlab进行数值模拟,证实了由超椭球模型所得结论的有效性;结果显示:超椭球模型能有效减缓因果图获取精确数据的难度,比区间模型下的范围对因果图更加具有可靠性和实际意义。

Laparoscopic resection for incidentally detected Meckel diverticulum

The management of Meckel diverticulum found un-expectedly during an abdominal operation remains controversial. Most published reports have included only patients undergoing diverticulectomy or bowel resection through laparotomy. We report a case of a carcinoid tumor in a Meckel’s diverticulum which was incidentally detected and removed during laparoscopic inguinal hernia repair. Although there is no compelling evidence in the literature to recommend prophylactic diverticulectomy, laparoscopic stapled resection repre-sents a viable and safe approach in healthy individuals undergoing elective surgery for other purposes.