新疆地区四地州苯丙酮尿症患者特食治疗随访依从性的影响因素

目的 了解新疆地区四地州苯丙酮尿症(PKU)患者低/无苯丙氨酸特殊医学用途配方食品(以下简称特食)治疗随访依从性的影响因素,为规范PKU患者的随访,保证特食治疗效果提供依据。方法 调查2010年1月—2020年12月在乌鲁木齐市妇幼保健院治疗随访≥1年以上的PKU患者,对其照护人进行访谈、问卷调查,收集整理PKU患者特食治疗现状,分析特食治疗随访依从性的影响因素。结果 不同筛查情况,接受过新生儿疾病筛查、新生儿基因确诊、母亲孕期唐氏筛查检查的患者依从性较好,差异有统计学意义(χ^(2)=5.753、10.993、9.189,P<0.05)。不同家庭情况,父母亲文化程度为大专及以上者PKU患者的特食治疗依从性较高,差异有统计学意义(χ^(2)=8.321、7.415,P<0.05);父母亲有固定职业的家庭其依从性较高,差异有统计学意义(χ^(2)=20.626、7.895,P<0.05)。年龄、购买特食的间隔时间、送检血片的次数、正常年龄入学情况(χ^(2)=19.443、8.090、69.482、12.001,P<0.05)对PKU患者特食治疗随访依从性存在影响。结论 PKU是一种可以治疗的遗传代谢性疾病,结合临床实际加强健康宣教,制订规范的随访方案及流程,提升随访治疗依从性,为提高PKU患者治疗随访成效起到重要作用。

治疗特食的选择

医生根据住院病人所患疾病的不同和病情的需要,要为病人选择各种不同种类饮食,特食就是其一.这些特食应如何选择和调配呢?本文作简要介绍.

Long-term follow-up after complete ablation of Barrett's esophagus with argon plasma coagulation

AIM: To report the long-term outcome of patients after complete ablation of non-neoplastic Barrett's esophagus (BE) with respect to BE relapse and development of intraepithelial neoplasia or esophageal adenocarcinoma. METHODS: In 70 patients with historically proven non neoplastic BE, complete BE ablation was achieved by argon plasma coagulation (APC) and high-dose proton pump inhibitor therapy (120 mg omeprazole daily). Sixty-six patients (94.4%) underwent further surveillance endoscopy. At each surveillance endoscopy four-quadrant biopsies were taken from the neo-squamous epithelium at 2 cm intervals depending on the pre-treatment length of BE mucosa beginning at the neo-Z-line, and from any endoscopically suspicious lesion. RESULTS: The median follow-up of 66 patients was 51 mo (range 9-85 mo) giving a total of 280.5 patient years. A mean of 6 biopsies were taken during surveillance endoscopies. In 13 patients (19.7%) tongues or islands suspicious for BE were found during endoscopy. In 8 of these patients (12.1%) non-neoplastic BE relapse was confirmed histologically giving a histological relapse rate of 3% per year. In none of the patients, intraepithelial neoplasia nor an esophageal adenocarcinoma was detected. Logistic regression analysis identified endoscopic detection of islands or tongues as the only positive predictor of BE relapse (P= 0.0004). CONCLUSION: The long-term relapse rate of non neoplastic BE following complete ablation with high-power APC is low (3% per year).

Cardiac mucosa indicates risk for Barrett esophagus

TO THE EDITORWith interest we read the article by Bani-Hani et al enrifled ＂Pathogenesis of columnar-lined esophagus＂, which has been published in the recent issue of World Journal of Gastroenterology. The review profoundly adds to our understanding of columnar-lined esophagus （CLE） and clearly indicates that CLE represents an acquired condition and develops as a consequence of gastroesophageal reflux disease （GERD）. However, it should be pointed out that inclusion of CLE-histopathology helps to define those at risk for dysplastic and malignant transformation. Histopathology characterizes nondysplastic and dyplastic （low-, high grade dysplasia） CLE.

Distinction between short-segment Barrett's esophageal and cardiac intestinal metaplasia

AIM： To investigate the roles of mucin histochemistry, cytokeratin 7/20 （CK7/20） immunoreactivity, clinical characteristics and endoscopy to distinguish short- segment Barrett＇s esophageal （SSBE） from cardiac intestinal metaplasia （CIM）. METHODS： High iron diamine/Alcian blue （HID/AB） mucin-histochemical staining and immunohistochemical staining were used to classify intestinal metaplasia （IN） and to determine CK7/20 immunoreactivity pattern in SSBE and CIM, respectively, and these results were compared with endoscopical diagnosis and the positive rate of gastroesophageal reflux disease （GERD） symptoms and H pylori infection. Long-segment Barrett＇ s esophageal and IM of gastric antrum were designed as control. RESULTS： The prevalence of type III IM was significantly higher in SSBE than in CIM （63.33% vs 23.08%, P〈0.005）. The CK7/20 immunoreactivity in SSBE showed mainly Barrett＇s pattern （76.66%）, and the GERD symptoms in most cases which showed Barrett＇ s pattern were positive, whereas H pylori infection was negative. However, the CK7/20 immunoreactivity in CIM was gastric pattern preponderantly （61.54%）, but there were 23.08% cases that showed Barrett＇s pattern. H pylori infection in all cases which showed gastric pattern was significantly higher than those which showed Barrett＇ s pattern （63.83% vs 19.30%, P〈0.005）, whereas the GERD symptoms in gastric pattern were significantly lower than that in Barrett＇s pattern （21.28% vs 85.96%,P〈O.O05）. CONCLUSION： Distinction of SSBE from CIM should not be based on a single method; however, the combination of clinical characteristics, histology, mucin histochemistry, CK7/20 immunoreactivity, and endoscopic biopsy should be applied. Type III IM, presence of GERD symptoms, and Barrett＇s CK7/20 immunoreactivity pattern may support the diagnosis of SSBE, whereas non-type III IM, positive H pylori infection, and gastric CK7/20 immunoreactivity pattern may imply CIM.

The clinical features of thoracic stomach cancer after surgical treatment for esophageal carcinoma

Objective:Postoperative recurrence of esophageal carcinoma was the main factor that affect the patients' survival and quality of life.This study mainly investigated the clinical features of thoracic stomach cancer (TSC) after surgical treatment for esophageal carcinoma.Methods:We retrospectively reviewed 51 cases of postoperative TSC in our hospital (Henan Province Tumor Hospital,Zhengzhou,China).Results:The 51 (10.97%) of all 465 cases that underwent endoscope after surgical treatment for esophageal carcinoma in our hospital were TSCs.There were 13 cases with complicating anastomotic recurrence.The locations of 46 cases (90.2%) were the same as the primary cancer.The 48 cases were squamous cell carcinomas and 3 cases were adenocarcinomas after esophagectomy for esophageal carcinoma.Endoscopic manifestations were puffiness-infiltrating type at 39.2% (20/51),massive type at 15.7% (8/51),ulcerative type at 7.8% (4/51) and ulcerative infiltrating type at 3.9% (2/51) and stenotic type etc.Conclusion:The incidence of TSC after surgical treatment for esophageal carcinoma is high.The main cause was that the local residual cancer invaded gastric wall.The gastroscopic features of TSC are different from those of gastric cancer.Regular review with endoscopy in postoperative esophageal carcinoma patients was a major way to diagnose TSC.

Study on Development of Formulated Feed for Improving Growth and Pigmentation of Koi Carp （Cyprinus carpio L,, 1758） Juveniles

The aim of the present study was to develop a formulated feed for improving skin pigmentation and growth performance of koi carp juveniles. Two experiments were conducted for determination of an optimal dietary astaxanthin and FM （fish meal） ration for koi carp juveniles. In the first experiment, three isonitrogenous and isoenergetic dietary treatments were designed with three different levels of astaxanthin consisted of 60, 80 and 100 mg/kg and a commercial feed served as a control. For the second experiment, four isonitrogenous and isoenergetic dietary treatments were formulated with graded inclusions of dietary FM replaced from 0% to 60% at 20% increments by SM （soybean meal）, PBM （poultry by-product meal）, and a CD （control diet）. Obtained results demonstrated that skin pigmentation of koi carp juveniles fed the diet containing 80 mg/kg astaxanthin, 36.02% protein, 7.78% lipid, 4.20 Kcal/g GE （gross energy） were more better than those at the diet with lower estaxanthin content and commercial diet. Moreover, the highest growth and feed utilization of fish were observed at this diet with WG （weight gain）, SGR （specific growth rate） and FCR （feed conversion ratio） were 121.80%, 0.95 （%/day） and 1.6, respectively.