福建省发现一种新的草亲鱼病

1978年5月，我们在闽候县养殖场一口亲鱼池内发现草亲鱼体上患有一种病，这种病很像打印病。由於当时忙於紧张的催产，故把它误认为是草鱼的打印病<见水产科技1979．2>。根据确关资料报导，草鱼对打印病具有先天性免疫力。所以，草亲鱼体上患有这种病是较少见的。而引起该病的病因和病原体尚有待於进一步探讨。

Infliximab stopped severe gastrointestinal bleeding in Crohn's disease

To report the result of rapid ulcer healing by infliximab in Crohn's patients with severe enterocolic bleeding. During 2005 and 2010, inflammatory bowel disease database of King Chulalongkorn Memorial and Samitivej hospitals were reviewed. There were seven Crohn's disease (CD) patients (4 women and 3 men; mean age 52 ± 10.4 years; range: 11-86 years). Two of the seven patients developed severe gastrointestinal bleeding (GIB) as a flare up of CD whereas the other five patients presented with GIB as their first symptom for CD. Their mean hemoglobin level dropped from 12 ± 1.3 g/ dL to 8.7 ± 1.3 g/dL in a 3-d period. Median packed red blood cells units needed for resuscitation was 4 units. Because of uncontrolled bleeding, surgical resection was considered. However, due to the poor surgical candidacy of these patients (n = 3) and /or possible development of short bowel syndrome (n = 6), surgery was not pursued. Likewise angiographic embolization was not considered in any due to the risk of large infarction. All severe GIBs successfully stopped by one or two doses of intravenous infliximab. Our data suggests that infliximab is an alternative therapy for CD with severe GIB when surgery has limitation or patient is a high risk.

Treatment and follow-up of children with transient congenital hypothyroidism

Objective： To study the clinical therapy and prognosis in children with transient congenital hypothyroidism （CH）. Methods： Fifty-seven children with CH diagnosed after neonatal screening were treated with low-dosage levothyroxine （L-T4）. Follow-up evaluation included the determination of TT3, TT4 and TSH serum levels and the assessment of thyroid gland morphology, bone age, growth development and development quotients （DQ）. A full check-up was performed at age 2, when the affected children first discontinued the L-T4 treatment for 1 month, and one year later. Development quotients were compared with a control group of 29 healthy peers. Results： The initial L-T4 dosage administered was 3.21-5.81μg/（kg·d） with an average of （16.25±3.87）μg/d. Mean duration of therapy was （28.09±9.56） months. No significant difference was found between study group and control group in the DQ test （average score （106.58±14.40） vs （102.4±8.6）, P〉0.05） and 96.49% of the CH children achieved a test score above 85. Bone age, 99mTc scans and ultrasonographic findings were all normal, and evaluation of physical development was normal too, as were the serum levels of TT3, TT4 and TSH after one year of follow-up. Conclusion： AL-T4 dosage of 3.21-5.81μg/（kg·d） was found sufficient for the treatment of transient CH. The treated children showed satisfactory overall mental and physical development at age 2. So it is possible for CH children to stop taking medicine if their laboratory findings and physical development are all normal after regular treatment and 2-3 years of follow-up.

Effect of 2-(8-hydroxy-6-methoxy-1-oxo-1H-2-benzopyran-3-yl) propionic acid in combination with carboplatin on gastric carcinoma growth in vivo

AIM： To investigate the effects of 2-（8-hydroxy-6- methoxy-l-oxo-lH-2-benzopyran-3-yl） propionic acid （NM-3） alone and in combination with carboplatin on tumor growth and apoptosis in mouse models of human gastric cancer constructed by subcutaneous implantation of histologically intact tumor tissue. METHODS： Human gastric cancer SGC-7901 tissues were implanted into the dorsal subcutis of nude mice. One week after tumors reached to a volume of 50-100 mm3 for around 1 wk, these mice were randomly divided into 8 groups （n = 10）. NM-3 was injected peritoneally at the dose of 10 mg/kg, 20 mg/kg or 40 mg/kg every other day for 5 wk, combined with carboplatin （5 mg/kg） every third day for 4 wk. As controls of combined treatment, another 4 groups of mice were injected with either NM-3 at 10 mg/kg, 20 mg/kg or 40 mg/kg, or with carboplatin alone （5 mg/kg）. The control mice received normal saline. Tumor weight, tumor growth inhibition （TGI）, and intratumoral microvessel density （MVD） were evaluated. Apoptosis of human gastric cancer was detected by TUNEL method and flow o/tometry analysis, respectively. RESULTS： The mean tumor volume （692.40 ± 58.43 mm3, 548.30 ± 66.02 mm3, 382.13 ± 43.52 mm3） after treatment with carboplatin combined NM-3 at the dose of 10 mg/kg, 20 mg/kg or 40 mg/kg was lower than that after treatment with either NM-3 at the dose of 10 mg/kg, 20 mg/kg or 40 mg/kg or with carboplatin alone. Compared with the normal saline group, NM-3 administered at 10 mg/kg, 20 mg/kg or 40 mg/kg significantly reduced the tumor weight in these groups （P 〈 0.05）. Carboplatin used alone at 5 mg/kg showed minimal effects. But NM-3 in combination with carboplatin had greater effects of tumor weight than either NM-3 or carboplatin alone. NM-3 alone at the dose 10 mg/kg or in combination with carboplatin had no obvious effects on body changes. Two mice died of diarrhea in each of the two groups treated with 40 mg/kg NM-3 or with 40 mg/kg NM-3 in combination with carboplatin. A significant increase in apoptosis was observed in the NM-3 treated groups, and the effect was more significant in the groups treated with carboplatin in combination with NM-3 at 10 mg/kg, 20 mg/kg and 40 mg/kg, than in the control group. The induction of apoptosis was positively associated with the dose of NM-3. NM-3 significantly reduced the neomicrovascular formation of gastric cancer. The MVD was lower in the groups treated with NM-3 or with NM-3 in combination with carboplatin than in the group treated with carboplatin or in the normal saline group （P 〈 0.05）. CONCLUSION： The results suggest that the inhibitory effect of NM-3 on gastric cancer growth is mediated through decreased angiogenesis and the increased induction of apoptosis. Furthermore, NM-3 alone at the dose of 10 mg/kg or in combination with carboplatin has no obvious effects on body changes, indicating that NM-3 in combination with carboplatin may be effective in the treatment of gastric cancer. The toxicity of NM-3 needs further studies.

A clinical dilemma:abdominal tuberculosis

AIM:To evaluate the clinical,radiological and microbiological properties of abdominal tuberculosis (TB) and to discuss methods needed to get the diagnosis. METHODS:Thirty-one patients diagnosed as abdominal TB between March 1998 and December 2001 at the Gastroenterology Department of Kartal State Hospital, Istanbul,Turkey were evaluated prospectively.Complete physical examination,medical and family history,blood count erythrocyte sedimentation rate,routine biochemical tests, Mantoux skin test,chest X-ray and abdominal ultrasonography (USG) were performed in all cases,whereas microbiological examination of ascites,upper gastrointestinal endoscopy,colonoscopy or barium enema,abdominal tomography,mediastinoscopy,laparoscopy or laparotomy were done when needed. RESULTS:The median age of patients (14 females,17 males) was 34.2 years (range 15-65 years).The most frequent symptoms were abdominal pain and weight loss. Eleven patients had active pulmonary TB.The most common abdominal USG findings were ascites and hepatomegaly.Ascitic fluid analysis performed in 13 patients was found to be exudative and acid resistant bacilli were present in smear and cultured only in one patient with BacTec (3.2%).Upper gastrointestinal endoscopy yielded nonspecific findings in 16 patients.Colonoscopy performed in 20 patients showed ulcers in 9 (45%),nodules in 2 (10%) and,stricture,polypoid lesions,granulomatous findings in terminal ileum and rectal fistula each in one patient (5%). Laparoscopy on 4 patients showed dilated bowel loops, thickening in the mesentery,multiple ulcers and tubercles on the peritoneum.Patients with abdominal TB were divided into three groups according to the type of involvement. Fifteen patients (48%) had intestinal TB,11 patients (35.2%) had tuberculous peritonitis and 5 (16.8%) tuberculous lymphadenitis.The diagnosis of abdominal TB was confirmed microbiologically in 5 (16%) and histo- pathologically in 19 patients (60.8%).The remaining nine patients (28.8%) had been diagnosed by a positive response to antituberculous treatment. CONCLUSION:Neither clinical signs,laboratory,radiological and endoscopic methods nor bacteriological and histopathological findings provide a gold standard by themselves in the diagnosis of abdominal TB.However,an algorithm of these diagnostic methods leads to considerably higher precision in the diagnosis of this insidious disease which primarily necessitate a clinical awareness of this serious health problem.

Fructose-sorbitol ingestion provokes gastrointestinal symptoms in patients with eating disorders

AIM:To evaluate gastrointestinal(GI) symptoms and breath hydrogen responses to oral fructose-sorbitol(F-S) and glucose challenges in eating disorder(ED) patients.METHODS:GI symptoms and hydrogen breath concentration were monitored in 26 female ED inpatients for 3 h,following ingestion of 50 g glucose on one day,and 25 g fructose/5 g sorbitol on the next day,after an overnight fast on each occasion.Responses to F-S were compared to those of 20 asymptomatic healthy females.RESULTS:F-S provoked GI symptoms in 15 ED patients and one healthy control(P < 0.05 ED vs control) .Only one ED patient displayed symptom provocation to glucose(P < 0.01 vs F-S response) .A greater symptom response was observed in ED patients with a body mass index(BMI) ≤ 17.5 kg/m 2 compared to those with a BMI > 17.5 kg/m 2(P < 0.01) .There were no differences in psychological scores,prevalence of functional GI disorders or breath hydrogen responses between patients with and without an F-S response.CONCLUSION:F-S,but not glucose,provokes GI symptoms in ED patients,predominantly those with low BMI.These findings are important in the dietary management of ED patients.

Ectopic fascioliasis mimicking a colon tumor

Fasciola hepatica, a leaf shaped trematode that is common in cattle, sheep and goats, is acquired by eating raw water plants like watercress or drinking water infected with the encysted form of the parasite. The varied clinical presentations of fascioliasis still make a high index of suspicion mandatory. Besides having a wide spectrum of hepatobiliary symptoms like obstructive jaundice, cholangitis and liver cirrhosis, the parasitic infection also has extrabiliary manifestations. Until recently, extrahepatic fascioliasis has been reported in the subcutaneous tissue, brain, lungs, epididymis, inguinal lymph nodes, stomach and the cecum. In this report, a strange manifestation of the fasciola infection in a site other than the liver, a colonic fascioliasis, is presented.

Analysis of the Influence of New Usages on the State of Conservation of Historical Buildings through Microclimate Characterization

Recycling is an alternative for preserving historical heritage buildings. Through such process, buildings are occupied by new usages that assure they are not abandoned. However, conservation issues, like pathological manifestations by filamentous fungi, are common even in buildings receiving new uses. Thus, it is extremely important to know the microclimate behavior of these buildings and analyze if there are usages that favor the appearance of filamentous fungi or not. This study aims to verify if new usages modify the microclimate in historical buildings and if such possible change favors the appearance of pathological manifestations by filamentous fimgi in some specific use. To achieve the results, three buildings that have gone through recycling processes were chosen in the city of Pelotas, in Southernmost Brazil. The city possesses a large number of buildings with historical value and its climate conditions are propitious for appearance of filamentous fungi. For 12 months, microclimate was monitored, the environments modus operandi was characterized and there was a survey on the pathological manifestations by filamentous fungi in the three buildings with two different uses： administration offices and exhibition rooms. Conclusion was that usages that allow natural ventilation and lighting favor conservation, which is what happens in the ones used as administration offices. Besides that, it was noticed that the construction system also influences, since buildings with a high cellar that is being used did not present filamentous fungi, which also shows the influence of ascending humidity on the appearance of such pathological manifestations.

Celiac disease manifested by polyneuropathy and swollen ankles

A 27-year-old male started to have his ankles swollen during his military service. He was examined at a military hospital where electromyoneurography showed the signs of distal sensory-motor polyneuropathy with axon demyelinization and weak myopathic changes, whereas histopathological examination of gastrocnemius muscle biopsy revealed some mild and nonspecific myopathy. Besides, he was found to have subcutaneous ankle tissue edemas and hypertransaminasemia. Due to these reasons, he was dismissed from the military service and examined at another hospital where bone osteodensitometry revealed low bone mineral density of the spine. However, his medical problems were not resolved and after the second discharge from hospital he was desperately seeing doctors from time to time. Finally, at our institution he was shown to have celiac disease (CD) by positive serology (antitissue transglutaminase and antiendomysial antibodies) and small bowel mucosal histopathological examination, which showed total small bowel villous atrophy. Three months after the initiation of gluten-free diet, his ankle edema disappeared, electromyoneurographic signs of polyneuropathy improved and liver aminotransferases normalized. Good knowledge of CD extraintestinal signs and serologic screening are essential for early CD recognition and therapy.

Analysis of the Thyroid Carcinoma Incidence in Tianjin Over a Recent Twenty-Year Period

OBJECTIVE To analyze the incidence rate and trend of thyroid cancer in Tianjin over a recent 20-year period. METHODS A method of descriptive epidemiology was used to study the occurrence of thyroid cancer. RESULTS During 1981-2001, the average incidence rate of thyroid cancer was 1.770 per 100,000 with a male to female incidence ratio of 1： 2.74, the occurrence being higher in females than in males. Thyroid cancer incidence increased gradually with time over the 20 years in both males and females, especially the incidence peaked in females of 35-50 years of age. CONCLUSION The rapid increase in the incidence rate of thyroid cancer, especially in females, suggests that further research on the risk factors and preventive efforts related to high-risk women should be conducted.