Upper gastrointestinal bleeding as an unusual manifestation of localized Ménétrier’s disease with an underlying lipoma:A case report

BACKGROUND Ménétrier’s disease is a rare condition characterized by enlarged gastric folds,usually located in the whole body and fundus of the stomach.This report presents an unusual case of localized Ménétrier’s disease elevated by a submucosal lipoma and thus looking like a polypoid mass and causing an episode of upper gastrointestinal bleeding.The mass was successfully removed with endoscopic submucosal dissection.CASE SUMMARY Esophagogastroduodenoscopy was performed on a 76-year-old male patient after an episode of upper gastrointestinal bleeding,manifesting as fatigue and melena.A large polypoid mass(4 cm×1 cm)with enlarged mucosal folds was found in the body of the stomach,between the lesser curvature and posterior wall.A small ulcer at the distal end of the mass was identified as the source of the bleeding.Biopsy was negative for neoplasia.Computed tomography showed a submucosal lesion beneath the affected mucosa,most likely a lipoma.The mass was removed en bloc with tunneling endoscopic submucosal dissection.Final pathology determined that the mass included Ménétrier’s disease and a submucosal lipoma.The patient was scheduled for follow-up esophagogastroduodenoscopy.CONCLUSION Localized Ménétrier’s disease can coexist with a submucosal lipoma creating a polypoid mass with risk of bleeding.

Curative resection with endoscopic submucosal dissection of early gastric cancer in Helicobacter pylori-negative Ménétrier’s disease:A case report

BACKGROUND Adult-onset Ménétrier’s disease is strongly associated with Helicobacter pylori(H.pylori)infection and an elevated risk of carcinogenesis.Cases of early-stage gastric cancer developed in H.pylori-negative Ménétrier’s disease are extremely rare.We report a case of early gastric cancer in H.pylori-negative Ménétrier’s disease that was curatively resected with endoscopic submucosal dissection(ESD).CASE SUMMARY A 60-year-old woman was referred to our hospital after her medical examination detected anemia.Contrast-enhanced upper gastrointestinal(UGI)radiography revealed translucency of the nodule-aggregating surface with giant rugae.Blood tests showed hypoproteinemia and were negative for serum H.pylori immunoglobulin G antibodies.The 99mTc-DTPA-human serum albumin scintigraphy showed protein loss from the stomach.UGI endoscopy showed a 40-mm protruding erythematous lesion on giant rugae of the greater curvature of lower gastric body,suggesting early-stage gastric cancer due to Ménétrier’s disease.En bloc resection with ESD was performed for diagnosis and treatment.Histology of ESD showed well-differentiated tubular adenocarcinoma.The cancer was confined to the mucosa,and complete curative resection was achieved.Foveolar hyperplasia and atrophy of the gastric glands were observed in non-tumor areas,histologically corresponding to Ménétrier’s disease.Three years after ESD,gastric cancer had not recurred,and Ménétrier’s disease remained in remission with spontaneous regression of giant gastric rugae.CONCLUSION Complete curative resection was achieved through ESD in a patient with earlystage gastric cancer and H.pylori-negative Ménétrier’s disease.

MNS血型系统同种抗体的分布、性质与免疫史研究

目的探讨MNS血型系统同种抗体在我院抗体筛查试验阳性的发生率和临床意义。方法回顾性分析我院2013年6月至2015年4月抗体筛查试验阳性患者中存在MNS血型系统同种抗体患者的临床资料,对其输血史、妊娠史、疾病特点进行总结分析。结果对41 550例患者进行抗体筛查试验,阳性者509例(1.2%),其中69例(69/509,13.6%)为MNS血型系统同种抗体。在此69例中,抗-M 64例,占92.8%;抗-N 2例,占2.9%;抗-S 3例,占4.3%;平均年龄(46.2±16.9)岁,有妊娠史者22例(31.9%),有输血史者14例(20.3%)。结论由于Ig G性质的抗体可引起新生儿溶血病(HDN),故应在明确孕产妇抗体筛查实验中的抗体性质后,及时为患者选择抗原阴性的血液作为储备,以确保其输血安全。MNS血型系统同种抗体可通过输血刺激产生,对于反复输血及器官移植患者,应定期做抗体筛查实验,并保留其结果,当鉴定出有特异性的同种抗体时,应给予相应抗原阴性交叉配血相合血液,以保证输血的安全性。

慈姑黑粉病病原菌名称的演变

慈姑黑粉病是慈姑生产中最重要的病害之一。病原菌最初被认为是慈姑实球黑粉菌。随着属名的变化,该病原菌被转移到虚球黑粉菌属称为慈姑虚球黑粉菌。最新研究表明,该病原菌与侵染可变慈姑的病原菌是同种,是畸形虚球黑粉菌的异名。本文说明了慈姑黑粉病病原菌名称演变原因以及最新进展,这对准确应用病原菌名称提供了参考依据。

探讨阿托伐他汀联合缬沙坦对冠心病患者冠状动脉病变程度及对患者血清脂蛋白、C反应蛋白水平的影响

目的 探讨阿托伐他汀联合缬沙坦对冠心病患者冠状动脉病变程度、血清脂蛋白、C反应蛋白的影响。方法 选择2015年9月~2016年9月期间在临海市第二人民医院诊断为冠心病患者95例,按随机数字表法分为观察组和对照组,对照组患者給予阿托伐他汀,观察组患者在对照组患者治疗的基础上联合缬沙坦治疗,对比2组患者治疗前后冠状动脉病变程度、患者血清脂蛋白水平及C反应蛋白水平。结果 治疗后观察组患者纤维斑块、钙化斑块、脂质斑块、混合斑块均有明显下降,且低于对照组患者,而对照组患者纤维斑块、钙化斑块治疗前后无明显变化,治疗后观察组患者HDL、LDL、TG、TC分别为（2.12±1.01）、（3.27±0.94）、（1.53±0.98）、（3.35±1.78）明显优于对照组患者,差异有统计学意义（P〈0.05）,治疗后2个月、3个月观察组患者C反应蛋白水平分别为（10.27±1.78）、（7.26±2.63）明显低于对照组患者,差异有统计学意义（P〈0.05）。结论 阿托伐他汀联合缬沙坦有助于减少冠脉斑块、调节脂代谢、降低C反应蛋白水平。