便检阴性的慢性型阿米巴痢疾37例临床病理分析

阿米巴痢疾（amebic dysentery），又称肠阿米巴病（intestinal amebiasis），是由致病性溶组织阿米巴原虫侵入结肠壁后所致的以痢疾症状为主的消化道传染病。病变多在回膏部结肠，易复发变为慢性。原虫亦可由肠壁经血流一淋巴或直接迁徙至肝、肺、脑等脏器成为肠外阿米巴病，尤以阿米巴肝脓肿最为多见。

层次分析法中判断矩阵一致性的简便检验方法

一、前言层次分析法作为一种简便的决策方法,以对各方案作定性分析和定量分析,从而为选择最优方案提供依据而被人们广为采用,但以往对判断矩阵的一致性进行检验较为烦锁,本文向大家介绍一种简便的检验方法。

基于固定优先级算法的便携式检定仪自动校准

针对研发的军用便携式检定仪计量校准的需求,设计了校准量值的传递与保证方案,提出一种基于固定优先级的自动校准算法.该算法中,占用相同校准资源的校准任务按优先级执行,占用不同校准资源的校准任务则并行执行,充分利用了校准资源.通过以太网接口进行数据通讯,设计了自动校准程序,实现了便携式检定仪自动化校准.

立式罐计量特性及油品便携检定仪的设计

立式金属罐是大宗液体石油产品的主要计量器具。说明了立式罐应具有的计量特性,指出了立式罐计量中存在的几个问题,并提出了一些建议:建立国家计量罐建造标准;加强计量方法的研究;提高立式罐的计量精度;加快计量自动化及网络化进程;解决底量增量修正的难题。介绍了立式罐的主要检定项目,设计了便携式立式罐检定仪,以单片机为核心,采用先进的芯片技术,实现了证书电子化,同时说明了其工作原理,并且给出了它的硬件框图和软件程序框图。

疗养人员便常规检查干扰因素分析

目的:疗养人员便常规检查一般包括便潜血检查和便常规镜检,其主 要目的是:了解消化道有无出血、炎症、寄生虫感染、恶性肿瘤等情况。 在粪便的采集、送检及检查过程中会受到诸多干扰因素的影响,这些影响 因素直接决定检查结果的准确性和完整性。便潜血检查常采用化学法和免 疫法进行检测,其干扰因素也主要来至于这两种不同的检测方法。便常规 镜检的干扰因素主要由粪便留取方式、标本送检过程、标本留取时间以及 检验医生的临床经验和技能操作水平所决定。疗养院因其与临床医院在职 能和保障任务上有所区分,内部医疗功能和结构也有所不同,使得疗养人 员在疗养院进行便常规检查时,其粪便留取、送检及检验等诸多环节与临 床医院有所区别:清晨疗养员在疗养科室住宿房间内利用取便盒自行留取 粪便标本;留取后由疗养科室医务人员统收取并统一送往检验科检查;检 验科在收到粪便标本后需在一定时间内完成对大量粪便标的检查。经过分 析和讨论,发现这些差别对便常规检查结果产生了一定的影响。

华支睾吸虫感染情况调查

目的 :分析肝吸虫的感染情况 ,为肝吸虫的防治提供依据。方法 :皮试法、直接涂片便检法。结果 :皮试法阳性率为 5 6.87% ,男女无显著性差异 ;便检法感染率为 68% ,男女感染率无显著性差异。结论 :吃生鱼是引起该地肝吸虫感染的主要原因 ,今后要加强肝吸虫病的宣传与治疗 。

地方年鉴编写杂谈

编辑地方年鉴内容繁多 ,主要从突出年鉴年度特色、地方特色 ,增强年鉴的知识性 ,增大年鉴信息量 ,提高年鉴便检性方面谈了实际操作的问题和长处。

Management of patients with stercoral perforation of the sigmoid colon:Report of five cases

To our knowledge, stercoral perforation of the colon is rarely seen with fewer than 90 cases reported in the literature till date. We explored the principles of management to prevent impending mortality in five patients with this condition. Five patients, two males and three females, whose median age was 64 years, had sustained stercoral perforation of the sigmoid colon. Chronic constipation was the common symptom among these patients. Three patients underwent a Hartmann＇s procedure and another two were treated with segmental colectomy with anastomosis and diverting colostomy. There was one surgical mortality and the other patients had an uneventful hospital stay. Timely intervention to prevent and/or treat any associated sepsis along with extensive peritoneal lavage and surgical intervention to remove diseased colonic tissue at the primary stercoral ulceration site coupled with aggressive therapy for peritonitis are key treatment modalities in salvaging patients presenting with stercoral perforation of the colon.

Stool-based DNA testing,a new noninvasive method for colorectal cancer screening,the first report from Iran

AIM： To detect tumor-associated DNA changes in stool samples among Iranian patients with colorectal cancer （CRC） compared to healthy individuals using BAT-26, p16 hypermethylation and long DNA markers. METHODS： Stool DNA was isolated from 45 subjects including 25 CRC patients and 20 healthy individuals using a new, fast and easy extraction method. Long DNA associated with tumor was detected using polymerase chain reaction method. Microsatellite studies were performed utilizing denaturating polyacrylamide gel to determine the instability of BAT-26. Methylation status of p16 promoter was analyzed using methylation-specific PCR （MSP）. RESULTS： The results showed a significant difference in existence of long DNA （16 in patients vs 1 in controls, P 〈 0.001） and p16 （5 in patients vs none in controls, P = 0.043） in the stool samples of two groups. Long DNA was detected in 64% of CRC patients; whereas just one of the healthy individuals was positive for Long DNA. p16 methylation was found in 20% of patients and in none of healthy individuals. Instability of BATo26 was not detected in any of stool samples. CONCLUSION： We could detect colorectal cancer related genetic alterations by analyzing stool DNA with a sensitivity of 64% and 20% and a specificity of 95% and 100% for Long DNA and p16 respectively. A non- invasive molecular stool-based DNA testing can provide a screening strategy in high-risk individuals. However, additional testing on more samples is necessary from Iranian subjects to determine the exact specificity and sensitivity of these markers.

Usefulness of fecal lactoferrin and hemoglobin in diagnosis of colorectal diseases

AIM:To evaluate prospectively usefulness of fecal lactoferrin(Lf)and fecal hemoglobin(Hb)in the diagnosis of colorectal diseases.METHODS:Fecal Lf and Hb were measured using ELISA in 872 patients before they underwent colorectal endoscopy.RESULTS:Lf was positive in 18(50%)of 36 patients with colorectal cancer,25(15.9%)of 157 with colorectal polyps,29(46.8%)of 62 with ulcerative colitis,and 25(62.5%)of 40(62.5%)with Crohn's disease.The Hb-positive rates were 50%,12.1%,41.9% and 32.5%,respectively.Of the 318 patients free of abnormalities by colorectal endoscopy,Lf was positive in 29(9.1%)and Hb was positive in 15(4.7%).Among patients with Crohn's disease,the Lf-positive rate was significantly higher than the Hb-positive rate.If either high Lf or Hb levels were considered positive,the positive rates rose to 61.1%,51.6%,and 67.5% in the colorectal cancer group,ulcerative colitis group,and Crohn's disease group,respectively.If both high Lf and Hb levels were rated positive,the positive predictive values(PPV)were 21% for colorectal cancer,33% for ulcerative colitis,and 17% for Crohn's disease,and PPV of high Hb level alone was 18%,25% and 13%,respectively.CONCLUSION:Fecal Lf and Hb were found useful in the detection of colorectal diseases,and the combination of the two measurements appears to increase the sensitivity and efficacy of diagnosis.

Effects of the viability of Lactobacillus rhamnosus GG on rotavirus infection in neonatal rats

AIM:To study the effects of live and dead Lactobacillus rhamnosus GG(GG) on rotavirus infection in a neonatal rat model.METHODS:At the age of 2 d,suckling Lewis rat pups were supplemented with either live or dead GG and the treatment was continued daily throughout the experi-ment.At the age of 5 and 6 d the pups received oral rotavirus(RV) SA-11 strain.The pups were sacrificed at the age of 7 or 8 d by decapitation.The gastrointestinal tract was removed and macroscopic observations were done.The consistency of feces in the colon was classified using a four-tier system.RV was detected from the plasma,small intestine,colon and feces by real-time quantitative polymerase chain reaction(PCR).RESULTS:In this neonatal rat model,RV induced a mild-to-moderate diarrhea in all except one pup of the RV-inoculated rats.RV moderately reduced body weight development from day 6 onwards.On day 7,after 2 d of RV infection,live and dead GG groups gained significantly more weight than the RV group without probiotics [36%(P = 0.001) and 28%(P = 0.031),respectively].In addition,when compared with the RV control group,both live and dead GG reduced the weight ratio of colon/animal body weight to the same level as in the healthy control group,with reductions of 22%(P = 0.002) and 28%(P < 0.001),respectively.Diarrhea increased moderately in both GG groups.However,the diarrhea incidence and severity in the GG groups were not statistically significantly different as compared with the RV control group.Moreover,observed diarrhea did not provoke weight loss or death.The RV control group had the largest amount of RV PCR-positive samples among the RV-infected groups,and the live GG group had the smallest amount.Rats receiving live GG had significantly less RV in the colon(P = 0.027) when compared with the RV control group.Live GG was also more effective over dead GG in reducing the quantity of RV from plasma(P = 0.047).CONCLUSION:Both live and dead GG have beneficial effects in RV infection.GG may increase RV clearance from the body and reduce colon swelling.

Comparison of a monoclonal antigen stool test (Hp StAR) with the ^(13)C-urea breath test in monitoring Helicobacter pylori eradication therapy

AIM： To evaluate the agreement between a mAb-based stool test （HP STAR） and the urea breath test （UBT） in monitoring （H pylon） infection after eradication therapy. METHODS： Patients with discordant results on UBT and Hp STAR underwent endoscopy with biopsies for rapid urease test, culture, and histology to confirm H pylori status. RESULTS： Among 250 patients （50±14 years）, 240 （96.0%） had concordant UBT and Hp STAR tests with a significant correlation between DOB and A values （R = 0.87; P〈0.0001）. The remaining 10 （4.0%） patients had discordant tests （positive Hp STAR and negative UBT） with the Hp STAR inaccurate in five cases （false positive） and UBT inaccurate in the other five cases （false negative）. The “maximal expected” sensitivity, specificity, ＋PV, -PV, ＋LR, and -LR were 91%, 100%, 100%, 97.4%, ∞, and 8.2 respectively, for the UBT, and 100%, 97.4%, 91%, 100%, 38.8, and 0, respectively, for the Hp STAR. Overall accuracy for both tests was 98%. CONCLUSION： Both the UBT and the Hp StAR are equally accurate in monitoring H pylori infection. Nowadays, the choice of the “best” non-invasive H pylori test in the post-treatment setting should be done not only in terms of diagnostic accuracy but also in view of cost and local facilities.

Colonoscopic evaluation of hematochezia in low and average risk patients for colorectal cancer:A prospective study

AIM: To relate the endoscopic findings in patients with hematochezia with regard to age in “low and average risk” for colorectal cancer (CRC) and to localize signifi cant lesions in order to identify patients who need sigmoidoscopy or total colonoscopy. METHODS: This prospective study was performed in an open access GI endoscopy unit. Out of 4322 consecutive patients undergoing colonoscopy, 918 reported hema- tochezia. The fi nal study group comprized 180 patients aged below 45 and 237 over 45. Main exclusion criteria were a 1st-degree family history of colorectal carcinoma, patients reporting blood mixed with stools and/or pro- gressive colonic symptoms, or patients who had under- gone colon surgery for neoplastic lesions. RESULTS: Total colonoscopy could be performed in 96% of patients. Abnormal findings were observed in 34.3% of the younger and in 65.7% of the older ones. Findings were the presence of polyps in the distal colon (n = 2) and IBD in the proximal colon (n = 29) in the group of the younger patients, and polyps (n = 15), IBD (n = 13), and carcinoma (n = 6, 4 of the lesions were located proximal to the splenic flexure) in the elderly. Our f indings suggest that the diagnostic potential of total colonoscopy in patients younger than 45 referring scant hematochezia, is not mandatory. By exploring only the distal tract of the colon we have misdiagnosed two cases of IBD located in the ascending colon. In this group of patients additional risk factors must be identifi ed before performing a total colonoscopy. Regarding the patients older than 45 yr, the exploration of the distal colon would have led to our overlooking a carcinoma, two neoplastic polyps and one IBD located in the proximal colon. CONCLUSION: Young patients with scant hematochezia but without risk factors for neoplasia do not need a totalcolonoscopy, whereas is mandatory performing a total colonoscopy in older patients even in the presence of anal pathology.

Ileoscopy in 39 hematochezia patients with normal colonoscopy

AIM： To assess the role of retrograde terminal ileoscopy in hematochezia patients with normal colonoscopy. METHODS： Between January 1997 and March 2005, 39 hematochezia patients （males 36, females 3, mean age 44.7 years） with a reported normal colonoscopy underwent a repeat colonoscopy. After reaching the cecum, attempt was made to localize the ileocecal valve and intubate the terminal ileum. Any abnormality in the mucosa of the terminal ileum was carefully recorded and biopsies were obtained from suspiciouslooking lesions. RESULTS： During the study period there were 39 patients admitted for hematochezia in whom colonoscopy till cecum did not reveal any abnormality. Fulllength colonoscopy till the cecum could be performed in all the patients. The terminal ileum could be intubated in 36 patients. No abnormality was noted in 31 patients. Ileal ulcers were noted in two patients. Noclularity along with ulceration of the ileal mucosa, a Dieulafoy＇s lesion, and an angiomatous malformation were noted in one patient each. Histological examination of the biopsies obtained from the ulcers revealed typical tuberculous lesion in the patient with nodularity and ulceration. One of the patients had typhoid ulcers and another had non-specific ulcers. CONCLUSION： Retrograde terminal ileoscopy gives limited but valuable information, in patients with hematochezia and should be attempted in all such patients.

Study of Helicobacter pylori genotype status in saliva,dental plaques,stool and gastric biopsy samples

AIM:To compare genotype of Helicobacter pylori(H.pylori) isolated from saliva,dental plaques,gastric biopsy,and stool of each patient in order to evaluate the mode of transmission of H.pylori infection.METHODS:This cross-sectional descriptive study was performed on 300 antral gastric biopsy,saliva,dental plaque and stool samples which were obtained from patients undergoing upper gastrointestinal tract endoscopy referred to endoscopy centre of Hajar hospital of Shahrekord,Iran from March 2010 to February 2011.Initially,H.pylori strains were identified by rapid urease test(RUT) and polymerase chain reaction(PCR) were applied to determine the presence of H.pylori(ureC) and for genotyping of voculating cytotoxin gene A(vacA) and cytotoxin associated gene A(cagA) genesin each specimen.Finally the data were analyzed by using statistical formulas such as Chi-square and Fisher's exact tests to find any significant relationship between these genes and patient's diseases.P < 0.05 was considered statistically significant,RESULTS:Of 300 gastric biopsy samples,77.66% were confirmed to be H.pylori positive by PCR assay while this bacterium were detected in 10.72% of saliva,71.67% of stool samples.We were not able to find it in dental plaque specimens.The prevalence of H.pylori was 90.47% among patients with peptic ulcer disease(PUD),80% among patients with gastric cancer,and 74.13% among patients with none ulcer dyspepsia(NUD) by PCR assay.The evaluation of vacA and cagA genes showed 6 differences between gastric biopsy and saliva specimens and 11 differences between gastric and stool specimens.94.42% of H.pylori positive specimens were cagA positive and all samples had amplified band both for vacA s and m regions.There was significant relationship between vacA s1a/m1a and PUD diseases(P = 0.04),s2/m2 genotype and NUD diseases(P = 0.05).No statically significant relationship was found between cagA status with clinical outcomes and vacA genotypes(P = 0.65).The evaluation of vacA and cagA genes showed 6 differences between gastric biopsy and saliva specimens and 11 differences between gastric and stool specimens,CONCLUSION:Regard to high similarity in genotype of H.pylori isolates from saliva,stomach and stool,this study support the idea which fecal-oral is the main route of H.pylori transmission and oral cavity may serve as a reservoir for H.pylori,however,remarkable genotype diversity among stomach,saliva and stool samples showed that more than one H.pylori genotype may exist in a same patient.

Localization of a Robotic Capsule for GI Motility Inspection with a Portable Ultrasonic System

The micro-systems used for in vivo physical inspection have many advantages over traditional methods. In order to aid diagnosis of gastrointestinal (GI) motility disorders, a capsule is developed for GI pressure and pH inspection. Localization of the capsule in GI tract with time is a necessary condition for subsequent data analysis and medical diagnosis. It is also a common problem facing all in vivo mobile micro-systems. An approach of segment localization by utilizing some key points along GI tract is proposed. A portable ultrasonic detecting device was designed for this purpose. Experiments under conditions similar to GI tract were carried out and the results proved the effectiveness and reliability of this method and the device.

Effect of special Hungarian probiotic kefir on faecal microflora

AIM： To investigate the effect of a four-week consumption of a special Hungarian probiotic agent （Biofir） on the faecal microflora in human healthy subjects.METHODS： The effect of Biofir with 10^6/cm^3 initial germs on the faecal microflora was studied in 120 healthy volunteers （71 females, 49 males）. The traditional Russian type kefir was used as control. The various germ groups and pH values were determined in wk 2, 4 and 6.RESULTS： The number of all microbes increased during the 4-week probiotic treatment. The number of microbes increased 4,3-fold in the control group and 6.8-fold in Biofir-treated group. The probiotic kefir caused multiplication of the probiotic flora, meanwhile the undesired bacteria multiplied in the control group. No significant change of pH values of the faeces was found in both groups.CONCLUSION： The Hungarian probiotic keflr （Biofir） is capable of promoting multiplication of probiotic bacterial flora in the large bowel.

PLC应用于喷泉控制系统的方案设计

采用PLC与计算机组成的喷泉控制系统,充分利用PLC的通信功能和编程特点,实现上位机与下位机之间的通信和控制,由远程计算机与PLC之间进行通信,通过PLC实现对喷泉各种水型和灯光的快速控制;另一方面,利用PLC的自诊断功能,可实现喷泉控制系统的故障诊断,不但缩短了维修时间,而且提高了控制系统的稳定性。

A case of intussuscepted Meckel’s diverticulum

We report colonoscopic features of an intussuscepted Meckel's diverticulum, presenting with hematochezia. A 35-year-old woman presented to the emergency room with acute onset, transient, sharp, severe epi-gastric pain that began 6 h earlier. Colonoscopy re-vealed a reddish, soft, fi st-sized polypoid lesion in the terminal ileum. The lesion was misinterpreted as a hematoma by an inexperienced endoscopist. The pa-tient began to complain of intermittent, severe peri-umbilical pain following the colonoscopic examination. Subsequent computed tomography showed an enteric intussusception. An exploratory laparotomy revealed an intussuscepted Meckel's diverticulum, with trans-mural infarction. Colonoscopy was of little use in as-sessing the intussusception. However, colonoscopic examination may be performed initially, especially in an intussuscepted Meckel's diverticulum present-ing with hematochezia. Endoscopists should note the endoscopic features of an intussuscepted Meckel's diverticulum.