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。

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.

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.

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.

Chronic constipation:Facilitator factor for development of varicocele

AIM:To evaluate the possible relationship between varicocele and chronic constipation.METHODS:Between April 2009 and May 2010,a total of 135 patients with varicocele or constipation and 120 healthy controls were evaluated.Patients were divided into two groups.In both groups detailed medical history was taken and all patients were examined physically by the same urologist and gastroenterologist.All of them were evaluated by color Doppler ultrasonography.All patients with constipation,except for the healthy controls of the second group,underwent a colonoscopy to identify the etiology of the constipation.In the first group,we determined the rate of chronic constipation in patients with varicocele and in the second group,the rate of varicocele in patients with chronic constipation.In both groups,the rate of the disease was compared with age-matched healthy controls.In the second group,the results of colonoscopies in the patients with chronic constipations were also evaluated.RESULTS:In the first group,mean age of the study and control groups were 22.9 ± 4.47 and 21.8 ± 7.21 years,respectively(P < 0.05).In the second group,mean age of the study and control groups were 52.8 ± 33.3 and 51.7 ± 54.3 years,respectively(P < 0.05).In the first group,chronic constipation was observed in 8 of the 69 patients with varicocele(11.6%) and 3 out of 60 in healthy controls(5%),respectively.In this regard,there was no statistical significance between varicocele patients and the healthy control(P = 0.37).In the second group,varicocele was observed in 16 of the 66 patients with chronic constipation(24.24%) and 12 out of 60 in healthy controls(20%) respectively.Similarly,there was no statistical significance between chronic constipation and healthy controls(P = 0.72).Internal/external hemorrhoids were detected in 4 of the 16 patients with chronic constipation and varicocele,in the second group.In the remaining 50 patients with chronic constipation 9 had internal/external hemorrhoids.In this regard,there was no statistical significance between chronic constipation and healthy controls(P = 0.80).CONCLUSION:Chronic constipation may not be a major predictive factor for the development of varicocele,but it may be a facilitator factor for varicocele.

Manometric assessment of idiopathic megarectum in constipated children

AIM: Chronic constipation is a frequent finding in children. In this age range, the concomitant occurrence of megarectum is not uncommon. However, the definition of megarectum is variable, and a few data exist for Italy.We studied anorectal manometric variables and sensation in a group of constipated children with megarectum defined by radiologic criteria. Data from this group were compared with those obtained in a similar group of children with recurrent abdominal pain.METHODS: Anorectal testing was carried out in both groups by standard manometric technique and rectal balloon expulsion test.RESULTS: Megarectum patients displayed discrete abnormalities of anorectal variables and sensation with respect to controls. In particular, the pelvic floor function appeared to be impaired in most patients.CONCLUSION: Constipated children with megarectum have abnormal anorectal function and sensation. These findings may be helpful for a better understanding of the pathophysiological basis of this condition.

Hirschsprung's disease:Is there a relationship between mast cells and nerve fibers?

AIM:To define the topography of mast cells and their numbers in cases of Hirschsprung's disease(HD)and non-HD,assess neural hypertrophy using imaging software and to study the relationship between mast cells and nerve fibers.METHODS:HE stained sections of 32 cases of chronic constipation in the age group of 0-14 years were reviewed for ganglion cells.AChE staining was performed on frozen sections of colonic and rectal biopsies.Based on their findings cases were divided into HD and non-HD and mast cells stained by toluidine blue were evaluated.Image analysis by computerized software was applied to S-100 stained sections for assessment of neural hypertrophy.RESULTS:Difference between number of mast cells in HD group(mean=36.44)and in non-HD group(mean =14.79)was statistically significant.Image analysis morphometry on S-100 stained sections served as a useful adjunct.The difference between number,size,and perimeter of the nerve fibers between HD and non-HD group was statistically significant.CONCLUSION:Mast cells are significantly increased in HD and their base line values are much higher in Indian children than that reported in Western literature.Their role in HD needs further research.Morphometry of S-100 stained nerve fibers is a useful adjunct to conventional methods for diagnosis of HD.