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Clinical Analysis of 8 Cases of with Peutz-Jeghers Syndrome and Literature Review

目的 分析Peutz-Jeghers综合征临床特点，以提高诊治水平。 方法 2008年11月-2010年1月对8例Peutz-Jeghers综合征的临床资料进行回顾性分析。 结果 男女各4例，年龄13～41岁，病程20 d～40年。8例均有黑斑和息肉，5例有明确的家族史。首发表现以腹痛为主，轻度抑郁表现2例，并发肠套叠2例，结肠癌1例。病理报告：错构瘤4例。外科手术治疗1例，结肠镜治疗6例，保守治疗1例。 结论 Peutz-Jeghers综合征易并发抑郁症、肠套叠和恶性肿瘤，患者需心理治疗和遗传咨询，肠镜下息肉切除是主要手段。

外科治疗Peuty-Jeghers综合征9例报告

肝硬变合并胆囊固醇息肉51例临床分析

Efficacy and safety of computer-aided detection(CADe) in colonoscopy for colorectal neoplasia detection: a meta-analysis

ObjectiveTo systematically evaluate the efficacy and safety of computer-aided detection (CADe) and conventional colonoscopy in identifying colorectal adenomas and polyps. MethodsThe PubMed, Embase, Cochrane Library, Web of Science, WanFang Data, VIP, and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) comparing the effectiveness and safety of CADe assisted colonoscopy and conventional colonoscopy in detecting colorectal tumors from 2014 to April 2023. Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias of the included literature. Meta-analysis was performed by RevMan 5.3 software. ResultsA total of 9 RCTs were included, with a total of 6 393 patients. Compared with conventional colonoscopy, the CADe system significantly improved the adenoma detection rate (ADR) (RR=1.22, 95%CI 1.10 to 1.35, P<0.01) and polyp detection rate (PDR) (RR=1.19, 95%CI 1.04 to 1.36, P=0.01). It also reduced the missed diagnosis rate (AMR) of adenomas (RR=0.48, 95%CI 0.34 to 0.67, P<0.01) and the missed diagnosis rate (PMR) of polyps (RR=0.39, 95%CI 0.25 to 0.59, P<0.01). The PDR of proximal polyps significantly increased, while the PDR of ≤5 mm polyps slightly increased, but the PDR of >10mm and pedunculated polyps significantly decreased. The AMR of the cecum, transverse colon, descending colon, and sigmoid colon was significantly reduced. There was no statistically significant difference in the withdrawal time between the two groups. Conclusion The CADe system can increase the detection rate of adenomas and polyps, and reduce the missed diagnosis rate. The detection rate of polyps is related to their location, size, and shape, while the missed diagnosis rate of adenomas is related to their location.

家族性腺瘤性息肉病的手术治疗

Multi-Centre Randomized Controlled Trial of Bi Yuan Shu Liquid on Patients with Chronic Nasal Sinusitis or Nasal Polyp after Endosoopic Sinus Surgery

Objective　To study the effect of Bi Yuan Shu Liquid on melioration of clinical symptoms and signs of chronic nasal sinusitis or nasal polyp patients after Functional Endosoopic Sinus Surgery (FESS), and discuss the effectiveness of Chinese composite medicine in the overall treatment after FESS. Methods　A total of 340 patients were randomly allocated to treatment group (n =170) and control group (n =170) according to simple randomization procedure. Patients in treatment group were administrated with quinolone, steroid, and Bi Yuan Shu Liquid, which were compared with those in control group who were given quinolone and steroid. Results　The apparent effect of treatment group and control group were 30.6% and 42.4% of 42.4% of ITT. Results by Wilcoxon signed rank test indicated that there was a statistically significant difference. Conclusions　Bi Yuan Shu Liquid may improve the effectiveness of sinus surgery, reduce the time course of antibiotics and hormones, and with out toxicity and side-effect.

Research Advance of Muir-Torre Syndrome

【Abstract】ObjectiveTo review recent studies on Muir-Torre syndrome (MTS) and to improve the knowledge about MTS.MethodsThe literatures in recent years on clinic and gene research of MTS were reviewed.ResultsMTS was is a rare autosomal-dominant disorder characterized by the predisposition to both sebaceous tumors (or multiple keratoacanthomas) and internal malignancies. Gastrointestinal cancers were the most common kind of internal malignancies in MTS patients(61%)，followed by genitourinary cancers(22%). In most cases(56%)，sebaceous tumors appeared after the emergence of internal maliganancy. Both hereditary nonpolyposis colorectal cancer(HNPCC) and MTS were caused by germline mutations in the DNA mismatch repair genes. MTS patients exhibit significantly more mutations in the hMSH2 than in the hMLH1. In these cases , both internal and skin tumors showed the characteristic of high microsatellite instability(MSI).ConclusionThe presence of sebaceous tumors(or multiple keratoacanthomas) necessitates the search for internal malignancies. It is mandatory that patients with MTS, as patients with HNPCC, should be regularly followed up to search new malignancies. Evaluation and monitoring of the family members of patients are also necessary. The patients and their families should be counseled for genetic test. Sequencing the hMSH2 gene should be the prior selection of further examinations when clinical manifestations, history and laboratory tests suggest MTS.

硫糖铝混悬凝胶混合血凝酶与血管夹用于防治内镜下息肉切除术后出血的随机对照研究

目的 探讨硫糖铝混悬凝胶混合血凝酶用于防治内镜下息肉切除术后出血的临床效果。 方法 纳入 2014 年 4 月—2015 年 3 月在消化内镜中心行内镜检查发现直结肠息肉，并行内镜下肠道息肉黏膜切除术患者 112 例，随机分成药物组和血管夹组，每组各 56 例，分别予以术后创面喷洒硫糖铝混悬凝胶混合血凝酶及血管夹止血处理，观察两种方法操作时间、止血成功率、术后再出血的发生率及创面愈合情况。 结果 药物组和血管夹组分别有 15 例和 13 例出现术中即时出血，两组差异无统计学意义（P>0.05）。两组术中观察均成功止血，未追加其他止血方法。药物组和血管夹组平均操作时间分别为（58±16）、（192±94） s，两组差异有统计学意义（P<0.05）。术后观察，药物组无再出血，血管夹组 1 例再出血，两组差异无统计学意义（P>0.05）。两组患者术后 1 个月复查创面均愈合良好。 结论 硫糖铝混悬凝胶混合血凝酶用于防治内镜下息肉切除术后出血是一种简单、经济、有效的止血方法。

眼底检查在家族性多发性息肉病随访观察中的价值

SURGICAL INTERVENTION FOR CANCEROUS POLYP OF LOW RECTAL

目的探讨低位直肠息肉恶变的合理的外科手术方式。方法对我院1997年1月至2001年12月收治的32例低位直肠息肉恶变患者的资料进行回顾性分析。 结果32例中经肛门局部切除20例，经腹前切除低位吻合（Dixon术）8例，经腹会阴联合切除（Miles’术）4例，其中27例术后给予放、化疗。28例获随访1~5年，2例死亡，余均无局部复发。 结论低位直肠息肉恶变手术方式的正确选择是达到“根除癌肿”、“改善患者生活质量”目的的关键，术中冰冻病理检查是手术方式选择的重要依据。