Absence of MutY homologue mutation in patients with multiple sporadic adenomatous polyps in Korea

AIM： Recently, germ-line mutation in the base excision repair gene MYH has been identified to cause a novel autosomal recessive form of familial adenomatous polyposis （FAP）. Interestingly, a striking evidence for MYH mutations within different ethnic groups has been demonstrated. In this study, we screened 30 patients with multiple adenomatous polyps for MYH mutations to assess its prevalence and ethnic specificity in Korea. METHODS： Thirty patients （21 men and 9 women; mean age 62.3 years） with multiple adenomatous polyps were examined for MYH mutations. The mean number of adenomas per patient was 10.0. Sixteen exonic regions and their intronic sequences were amplified by PCR and subjected to SSCP and DNA sequencing analyses. RESULTS： None of the patients was identified to carry any truncating or sequence alterations in MYH. Our screening for the mutational regions, which were recognized from Caucasian patients or affected Indian families, also failed to detect sequence substitutions. CONCLUSION： Mutation in MYHmay be rarely involved in the pathogenesis of multiple sporadic colorectal adenomas in Korean population, although a large-scale analysis will be required to clarify the presence of specific MYH variants in a subset of patients and their role in the predisposition of multiple colorectal adenomas in Korean population.

Effects of Huayu Xiaozheng Therapy on Recurrence of Multiple Endometrial Polyps After Electrotomy

Objective:To investigate the preventive effect of Huayu Xiaozheng therapy method of traditional Chinese medicine on the recurrence of multiple endometrial polyps after hysteroscopic electro resection.Methods:A total of 120 patients with blood stasis diagnosed with multiple endometrial polyps after hysteroscopic electroresection were divided into Traditional Chinese medicine group(38 people),Manyuele group(27 people),contraceptive pill group(34 people)and control group(21 people),and the endometrial thickness,polyp recurrence cases and TCM syndrome points were observed in 4 groups after treatment in 3 months,6 months and 12 months..Results:The endometrial thickness was statistically significant(P<0.05)before and after treatment in the Chinese medicine group,the Manyuele group and the contraceptive group,and the endometrial thickness was statistically significant(P<0.05)in the 1 year after treatment,and the endometrial thickness of the Chinese medicine group was compared with the contraceptive group and the Manyuele group in the 1 year after treatment,and the difference was not statistically significant.The differences in TCM symptoms in the Chinese medicine treatment group were statistically significant compared with those in the contraceptive group and the Manyuele group(P<0.05).The recurrence rate of polyps in the 1 year after treatment was statistically significant compared with the control group(P<0.05),and the difference between the three groups was not statistically significant(P>0.05).Conclusion:The traditional Chinese medicine stasis elimination method has a preventive effect on the recurrence of endometrial polyps,and its preventive effect is no different from that of Western medicine,and can significantly improve clinical symptoms.

Laparoscopic restorative proctocolectomy with ileal pouch-anal anastomosis for Peutz-Jeghers syndrome with synchronous rectal cancer

We report on a patient diagnosed with PeutzJeghers syndrome(PJS) with synchronous rectal cancer who was treated with laparoscopic restorative proctocolectomy with ileal pouch-anal anastomosis(IPAA). PJS is an autosomal dominant syndrome characterized by multiple hamartomatous polyps in the gastrointestinal tract, mucocutaneous pigmentation, and increased risks of gastrointestinal and nongastrointestinal cancer. This report presents a patient with a 20-year history of intermittent bloody stool, mucocutaneous pigmentation and a family history of PJS, which together led to a diagnosis of PJS. Moreover, colonoscopy and biopsy revealed the presence of multiple serried giant pedunculated polyps and rectal adenocarcinoma. Currently, few options exist for the therapeutic management of PJS with synchronous rectal cancer. For this case, we adopted an unconventional surgical strategy and ultimately performed laparoscopic restorative proctocolectomy with IPAA. This procedure is widely considered to be the first-line treatment option for patients with ulcerative colitis or familial adenomatous polyposis. However, there are no previous reports of treating PJS patients with laparoscopic IPAA. Since the operation, the patient has experienced no further episodes of gastrointestinal bleeding and has demonstrated satisfactory bowel control. Laparoscopic restorative proctocolectomy with IPAA may be a safe and effective treatment for patients with PJS with synchronous rectal cancer.

Danning tablets for the treatment of multiple gallbladder polyps: Study protocol of multicentre, randomised, open-labelled, controlled trial

Introduction:Gallbladder polyps(GPs)are protrusions of the gallbladder wall into the lumen,and are commonly detected during ultrasound examinations.Traditional management of multiple GPs(MGPs)has been conservative,including lifestyle interventions,regular monitoring,and surgical intervention in certain cases,but this approach poses risks of polyps enlargement and increase of number,as well as patients’psychological burdens.Danning Tablets,a traditional Chinese medicine,have emerged as a potential non-surgical treatment for GPs,showing promise in reducing polyp size and alleviating symptoms,backed by their anti-inflammatory and antitumor properties demonstrated in preclinical studies.This suggests the need for further research into Danning Tablets as an alternative treatment for MGPs.Methods and analysis:The study is designed as a prospective,randomized,controlled,open-label trial.The study will be conducted across multiple centres specializing in gastroenterology and hepatology.Participants will be recruited from these centres,ensuring a diverse patient demographic.Adult patients diagnosed with MGPs,based on ultrasound findings,will be included.Exclusion criteria include patients with a history of gallbladder cancer,previous gallbladder surgery,or serious comorbid conditions.The control group will receive standard care,including dietary and lifestyle advice,while the intervention group will receive Danning Tablets and standard care.The dosage and administration of Danning Tablets will follow established clinical guidelines.The primary outcome will be the change in size of the largest gallbladder polyps on week 24±1,measured by ultrasound.The secondary outcomes will include symptom improvement and recording of any adverse events.The study will span over a period of 6 months,with periodic assessments at baseline,4,8,12,and 24 weeks.