To assess the use of serum levels of angiopoietin-1 (Ang1), Ang2 and tumor necrosis factor-α (TNFα) as predictive factors for small bowel angiodysplasia (SBA). METHODSSerum samples were collected from patients under...To assess the use of serum levels of angiopoietin-1 (Ang1), Ang2 and tumor necrosis factor-α (TNFα) as predictive factors for small bowel angiodysplasia (SBA). METHODSSerum samples were collected from patients undergoing capsule endoscopy for any cause of obscure gastrointestinal bleeding (OGIB) or anaemia. Based on small bowel findings patients were divided into 3 groups: (1) SBA; (2) other bleeding causes; and (3) normal, according to diagnosis. Using ELISA technique we measured serum levels of Ang1, Ang2 and TNFα and compared mean and median levels between the groups based on small bowel diagnosis. Using receiver operator curve analysis we determined whether any of the factors were predictive of SBA. RESULTSSerum samples were collected from a total of 120 patients undergoing capsule endoscopy for OGIB or anaemia: 40 with SBA, 40 with other causes of small bowel bleeding, and 40 with normal small bowel findings. Mean and median serum levels were measured and compared between groups; patients with SBA had significantly higher median serum levels of Ang2 (3759 pg/mL) compared to both other groups, with no significant differences in levels of Ang1 or TNFα based on diagnosis. There were no differences in Ang2 levels between the other bleeding causes (2261 pg/mL) and normal (2620 pg/mL) groups. Using Receiver Operator Curve analysis, an Ang2 level of > 2600 pg/mL was found to be predictive of SBA, with an area under the curve of 0.7. Neither Ang1 or TNFα were useful as predictive markers. CONCLUSIONElevations in serum Ang2 are specific for SBA and not driven by other causes of bleeding and anaemia. Further work will determine whether Ang2 is useful as a diagnostic or prognostic marker for SBA.展开更多
In clinical practice,examination of the hemorrhagic spot (HS) remains difficult.In this paper,we describe a remote controlled capsule (RCC) micro-system with an automated,color-based sensor to identify and localize th...In clinical practice,examination of the hemorrhagic spot (HS) remains difficult.In this paper,we describe a remote controlled capsule (RCC) micro-system with an automated,color-based sensor to identify and localize the HS of the gastrointestinal (GI) tract.In vitro testing of the detecting sensor demonstrated that it was capable of discriminating mimetic intestinal fluid (MIF) with and without the hemoglobin (Hb) when the concentration of Hb in MIF was above 0.05 g/ml.Therefore,this RCC system is able to detect the relatively accurate location of the HS in the GI tract.展开更多
Objective To analyze the diagnostic value of bedside capsule endoscopy in patients with acute or severeggastrointestinal bleeding.Methods Clinical data from patients who underwent bedside capsule endoscopy due to acut...Objective To analyze the diagnostic value of bedside capsule endoscopy in patients with acute or severeggastrointestinal bleeding.Methods Clinical data from patients who underwent bedside capsule endoscopy due to acute or severe suspected gastrointestinal bleeding in Nanfang Hospital,Southern Medical University from June 2018 to September 2021 were analyzed retrospectively.The efficacy of capsule endoscopy in detecting upper gastrointestinal tract and small intestinal bleeding was evaluated.Results A total of 74 patients underwent bedside capsule endoscopy for suspected acute or severe gastrointestinal bleeding.Five patients were excluded due to failure of examination due to retention of capsule endoscope in the gastric lumen,and 69 were included in the study,of whom 54 patients with a definitive diagnosis of gastrointestinal hemorrhage.The positive detection rate of the capsule endoscopy was 83.33%(45/54),including 17 cases of ulcer,5 cases of erosion,5 cases of vascular malformation,4 protrusion mass,4 diverticulum,5 obscure gastrointestinal bleeding,1 stenosis,1 active mucosal blood exudation,1 gastric retention,1 mucosal swelling,and 1 mucosal wrinkle change.The sensitivity and specificity of capsule endoscopy in the diagnosis of upper gastrointestinal bleeding were 92.31%(12/13)and 75.00%(3/4)respectively.The sensitivity and specificity of capsule endoscopy for diagnosing small intestinal bleeding were 80.49%(33/41)and 90.91%(10/11)respectively.Conclusion Bedside capsule endoscopy demonstrates high sensitivity and specificity in the diagnosis of gastrointestinal bleeding,showing potential advantages in bedside applications for acute and severe gastrointestinal bleeding.展开更多
This paper discusses the application of montmorillonite powder in the treatment of acute small intestinal bleeding.This paper combines the research results at home and abroad to systematically discusses the mechanism,...This paper discusses the application of montmorillonite powder in the treatment of acute small intestinal bleeding.This paper combines the research results at home and abroad to systematically discusses the mechanism,clinical effect,adverse effects and precautions of montmorillonite powder in the treatment of acute small intestinal bleeding.Combined with the domestic and foreign research methods,the domestic research emphasizes its deep research in pharmacology,clinical application and basic research,providing support for its wide application in the domestic medical field.Foreign studies have highlighted that montmorillonite powder not only has unique advantages in the treatment of acute small intestinal bleeding by regulating the balance of intestinal flora and enhancing immunity,but also provides a new therapeutic idea for its combined application with other drugs.Domestic and foreign research progress shows that montmorillonite powder has achieved some efficacy in the treatment of acute small intestinal bleeding,however,despite the significant progress,its mechanism of action and application method still need to be further studied.In the future,multidisciplinary cooperation should be strengthened to develop safer and more effective treatment options through in-depth research to provide more comprehensive medical services for patients with acute small bowel bleeding.展开更多
Small intestinal hemolymphangioma is a very rare benign tumor.There was only one report of a hemolymphangioma of the pancreas invading to the duodenum until March 2011.Here we describe the first case of small intestin...Small intestinal hemolymphangioma is a very rare benign tumor.There was only one report of a hemolymphangioma of the pancreas invading to the duodenum until March 2011.Here we describe the first case of small intestinal hemolymphangioma with bleeding in a 57-year-old woman.She presented with persistent gastrointestinal bleeding and endoscopy revealed a small intestinal tumor.Partial resection of the small intestine was thus performed and the final pathological diagnosis was hemolymphangioma.We also highlight the difficultly in making an accurate preoperative diagnosis in spite of modern imaging techniques.To arrive at a definitive diagnosis and exclude malignancy,partial resection of the small intestine was considered to be the required treatment.展开更多
Digestive tract hemorrhage is a common disease of the digestive system, but about 0. 4% -5% intestinal bleeding can not be detected with gastroscope or colonscope. 1 Since the intestine is long, tortuous, far away fro...Digestive tract hemorrhage is a common disease of the digestive system, but about 0. 4% -5% intestinal bleeding can not be detected with gastroscope or colonscope. 1 Since the intestine is long, tortuous, far away from both ends of the digestive tract and unfixed in position, clinical diagnosis of the bleeding is relatively difficult. Yamamoto and Sugano2 reported the clinical application of double-balloon enteroscope at American DDW in 2003. Since this new instrument can help to observe the entire intestine, obtain biopsy sample, mark lesions and carry out treatments, it has drawn the attention of researchers all over the world. In 2003, we successfully used Japanese Fujinon double-balloon enteroscope in detecting suspected intestinal hemorrhage in 57 patients.展开更多
Developing an oral in situ-forming hydrogel that targets the inflamed intestine to suppress bleeding ulcers and alleviate intestinal inflammation is crucial for effectively treating ulcerative colitis(UC).Here,inspire...Developing an oral in situ-forming hydrogel that targets the inflamed intestine to suppress bleeding ulcers and alleviate intestinal inflammation is crucial for effectively treating ulcerative colitis(UC).Here,inspired by sandcastle worm adhesives,we proposed a water-immiscible coacervate(EMNs-gel)with a programmed coacervate-to-hydrogel transition at inflammatory sites composed of dopa-rich silk fibroin matrix containing embedded inflammation-responsive core-shell nanoparticles.Driven by intestinal peristalsis,the EMNs-gel can be actuated forward and immediately transform into a hydrogel once contacting with the inflamed intestine to yield strong tissue adhesion,resulting from matrix metalloproteinases(MMPs)-triggered release of Fe3+from embedded nanoparticles and rearrangement of polymer network of EMNs-gel on inflamed intestine surfaces.Extensive in vitro experiments and in vivo UC models confirmed the preferential hydrogelation behavior of EMNs-gel to inflamed intestine surfaces,achieving highly effective hemostasis,and displaying an extended residence time(48 h).This innovative EMNs-gel provides a non-invasive solution that accurately suppresses severe bleeding and improves intestinal homeostasis in UC,showcasing great potential for clinical applications.展开更多
A 35-year-old man was admitted due to bloody stool and anemia. The bleeding source could not be detected by esophagogastroduodenoscopy or colonoscopy. Double balloon endoscopy (DBE) revealed a diverticulum-like hole i...A 35-year-old man was admitted due to bloody stool and anemia. The bleeding source could not be detected by esophagogastroduodenoscopy or colonoscopy. Double balloon endoscopy (DBE) revealed a diverticulum-like hole in which coagula stuck in the ileum at 1 meter on the oral side from the ileocecal valve. The adjacent mucosa just to the oral side of the hole was elevated like a submucosal tumor. The lesion was considered the source of bleeding and removed surgically. It was determined to be a cyst with an ileal structure on the mesenteric aspect accompanying gastric mucosa. The diagnosis was a duplication cyst of the ileum,which is a rare entity that can cause gastrointestinal bleeding. In the present case,DBE was used to fi nd the hemorrhagic duplication cyst in the ileum.展开更多
Radiotherapy is an essential method in the comprehensive treatment of malignant tumors.However,radiation proctitis(RP)is a common complication of pelvic tumors after radiotherapy.Due to RP's various etiology and c...Radiotherapy is an essential method in the comprehensive treatment of malignant tumors.However,radiation proctitis(RP)is a common complication of pelvic tumors after radiotherapy.Due to RP's various etiology and complex pathogenesis,it is currently no standard for traditional Chinese medicine(TCM)treatment.Professor Yuan-hong Zhao believes that refractory RP,which is named chronic hemorrhagic radiation proctitis(CHRP),should be classified as"Intestinal Wind Bleeding"(Bleeding like a note before defecation,bright red blood,no swelling and pain in the anus)and"Intestinal Afflux"(Refers to the symptoms of pus and blood in the lower mucus,similar to ulcerative colitis,peptic ulcer and other diseases in modern medicine.)in TCM.The critical pathogenesis of CHRP lies in local stasis and collaterals injury of intestinal collaterals.In general,it is a syndrome of excess and scarcity.External treatment with TCM is the preferred treatment strategy for CHRP,and the primary way is to disperse blood stasis and detoxify and nourish the intestinal collaterals.展开更多
The small intestine is an uncommon site of gastro-intestinal(GI)bleeding;however it is the commonest cause of obscure GI bleeding.It may require multiple blood transfusions,diagnostic procedures and repeated hospitali...The small intestine is an uncommon site of gastro-intestinal(GI)bleeding;however it is the commonest cause of obscure GI bleeding.It may require multiple blood transfusions,diagnostic procedures and repeated hospitalizations.Angiodysplasia is the commonest cause of obscure GI bleeding,particularly in the elderly.Inflammatory lesions and tumours are the usual causes of small intestinal bleeding in younger patients.Capsule endoscopy and deep enteroscopy have improved our ability to investigate small bowel bleeds.Deep enteroscopy has also an added advantage of therapeutic potential.Computed tomography is helpful in identifying extra-intestinal lesions.In cases of difficult diagnosis,surgery and intra-operative enteroscopy can help with diagnosis and management.The treatment is dependent upon the aetiology of the bleed.An overt bleed requires aggressive resuscitation and immediate localisation of the lesion for institution of appropriate therapy.Small bowel bleeding can be managed by conservative,radiological,pharmacological,endoscopic and surgical methods,depending upon indications,expertise and availability.Some patients,especially those with multiple vascular lesions,can re-bleed even after appropriate treatment and pose difficult challenge to the treating physician.展开更多
文摘To assess the use of serum levels of angiopoietin-1 (Ang1), Ang2 and tumor necrosis factor-α (TNFα) as predictive factors for small bowel angiodysplasia (SBA). METHODSSerum samples were collected from patients undergoing capsule endoscopy for any cause of obscure gastrointestinal bleeding (OGIB) or anaemia. Based on small bowel findings patients were divided into 3 groups: (1) SBA; (2) other bleeding causes; and (3) normal, according to diagnosis. Using ELISA technique we measured serum levels of Ang1, Ang2 and TNFα and compared mean and median levels between the groups based on small bowel diagnosis. Using receiver operator curve analysis we determined whether any of the factors were predictive of SBA. RESULTSSerum samples were collected from a total of 120 patients undergoing capsule endoscopy for OGIB or anaemia: 40 with SBA, 40 with other causes of small bowel bleeding, and 40 with normal small bowel findings. Mean and median serum levels were measured and compared between groups; patients with SBA had significantly higher median serum levels of Ang2 (3759 pg/mL) compared to both other groups, with no significant differences in levels of Ang1 or TNFα based on diagnosis. There were no differences in Ang2 levels between the other bleeding causes (2261 pg/mL) and normal (2620 pg/mL) groups. Using Receiver Operator Curve analysis, an Ang2 level of > 2600 pg/mL was found to be predictive of SBA, with an area under the curve of 0.7. Neither Ang1 or TNFα were useful as predictive markers. CONCLUSIONElevations in serum Ang2 are specific for SBA and not driven by other causes of bleeding and anaemia. Further work will determine whether Ang2 is useful as a diagnostic or prognostic marker for SBA.
基金Project supported by the National Natural Science Foundation of China (Nos. 30700160 and 30970883)the Postdoctoral Science Foundation of China (Nos. 20070420718 and 200801225)+1 种基金Chongqing University Postgraduates’ Science and Innovation Fund (No. 2008 01A1B0250284)the Specialized Research Fund for the Doctoral Program of Higher Education (No. 20070611045), China
文摘In clinical practice,examination of the hemorrhagic spot (HS) remains difficult.In this paper,we describe a remote controlled capsule (RCC) micro-system with an automated,color-based sensor to identify and localize the HS of the gastrointestinal (GI) tract.In vitro testing of the detecting sensor demonstrated that it was capable of discriminating mimetic intestinal fluid (MIF) with and without the hemoglobin (Hb) when the concentration of Hb in MIF was above 0.05 g/ml.Therefore,this RCC system is able to detect the relatively accurate location of the HS in the GI tract.
文摘Objective To analyze the diagnostic value of bedside capsule endoscopy in patients with acute or severeggastrointestinal bleeding.Methods Clinical data from patients who underwent bedside capsule endoscopy due to acute or severe suspected gastrointestinal bleeding in Nanfang Hospital,Southern Medical University from June 2018 to September 2021 were analyzed retrospectively.The efficacy of capsule endoscopy in detecting upper gastrointestinal tract and small intestinal bleeding was evaluated.Results A total of 74 patients underwent bedside capsule endoscopy for suspected acute or severe gastrointestinal bleeding.Five patients were excluded due to failure of examination due to retention of capsule endoscope in the gastric lumen,and 69 were included in the study,of whom 54 patients with a definitive diagnosis of gastrointestinal hemorrhage.The positive detection rate of the capsule endoscopy was 83.33%(45/54),including 17 cases of ulcer,5 cases of erosion,5 cases of vascular malformation,4 protrusion mass,4 diverticulum,5 obscure gastrointestinal bleeding,1 stenosis,1 active mucosal blood exudation,1 gastric retention,1 mucosal swelling,and 1 mucosal wrinkle change.The sensitivity and specificity of capsule endoscopy in the diagnosis of upper gastrointestinal bleeding were 92.31%(12/13)and 75.00%(3/4)respectively.The sensitivity and specificity of capsule endoscopy for diagnosing small intestinal bleeding were 80.49%(33/41)and 90.91%(10/11)respectively.Conclusion Bedside capsule endoscopy demonstrates high sensitivity and specificity in the diagnosis of gastrointestinal bleeding,showing potential advantages in bedside applications for acute and severe gastrointestinal bleeding.
文摘This paper discusses the application of montmorillonite powder in the treatment of acute small intestinal bleeding.This paper combines the research results at home and abroad to systematically discusses the mechanism,clinical effect,adverse effects and precautions of montmorillonite powder in the treatment of acute small intestinal bleeding.Combined with the domestic and foreign research methods,the domestic research emphasizes its deep research in pharmacology,clinical application and basic research,providing support for its wide application in the domestic medical field.Foreign studies have highlighted that montmorillonite powder not only has unique advantages in the treatment of acute small intestinal bleeding by regulating the balance of intestinal flora and enhancing immunity,but also provides a new therapeutic idea for its combined application with other drugs.Domestic and foreign research progress shows that montmorillonite powder has achieved some efficacy in the treatment of acute small intestinal bleeding,however,despite the significant progress,its mechanism of action and application method still need to be further studied.In the future,multidisciplinary cooperation should be strengthened to develop safer and more effective treatment options through in-depth research to provide more comprehensive medical services for patients with acute small bowel bleeding.
文摘Small intestinal hemolymphangioma is a very rare benign tumor.There was only one report of a hemolymphangioma of the pancreas invading to the duodenum until March 2011.Here we describe the first case of small intestinal hemolymphangioma with bleeding in a 57-year-old woman.She presented with persistent gastrointestinal bleeding and endoscopy revealed a small intestinal tumor.Partial resection of the small intestine was thus performed and the final pathological diagnosis was hemolymphangioma.We also highlight the difficultly in making an accurate preoperative diagnosis in spite of modern imaging techniques.To arrive at a definitive diagnosis and exclude malignancy,partial resection of the small intestine was considered to be the required treatment.
文摘Digestive tract hemorrhage is a common disease of the digestive system, but about 0. 4% -5% intestinal bleeding can not be detected with gastroscope or colonscope. 1 Since the intestine is long, tortuous, far away from both ends of the digestive tract and unfixed in position, clinical diagnosis of the bleeding is relatively difficult. Yamamoto and Sugano2 reported the clinical application of double-balloon enteroscope at American DDW in 2003. Since this new instrument can help to observe the entire intestine, obtain biopsy sample, mark lesions and carry out treatments, it has drawn the attention of researchers all over the world. In 2003, we successfully used Japanese Fujinon double-balloon enteroscope in detecting suspected intestinal hemorrhage in 57 patients.
基金Chongqing Postdoctoral International Exchange Training Program(7820100997)Fundamental Research Funds for Central Universities(Nos.SWU-XDPY22010)+2 种基金National College Students Innovation and Entrepreneurship Training Program(202310635114)National Natural Science Foundation of China(No.81703424)Chongqing Graduate Student Research Innovation Project(CYB21121).
文摘Developing an oral in situ-forming hydrogel that targets the inflamed intestine to suppress bleeding ulcers and alleviate intestinal inflammation is crucial for effectively treating ulcerative colitis(UC).Here,inspired by sandcastle worm adhesives,we proposed a water-immiscible coacervate(EMNs-gel)with a programmed coacervate-to-hydrogel transition at inflammatory sites composed of dopa-rich silk fibroin matrix containing embedded inflammation-responsive core-shell nanoparticles.Driven by intestinal peristalsis,the EMNs-gel can be actuated forward and immediately transform into a hydrogel once contacting with the inflamed intestine to yield strong tissue adhesion,resulting from matrix metalloproteinases(MMPs)-triggered release of Fe3+from embedded nanoparticles and rearrangement of polymer network of EMNs-gel on inflamed intestine surfaces.Extensive in vitro experiments and in vivo UC models confirmed the preferential hydrogelation behavior of EMNs-gel to inflamed intestine surfaces,achieving highly effective hemostasis,and displaying an extended residence time(48 h).This innovative EMNs-gel provides a non-invasive solution that accurately suppresses severe bleeding and improves intestinal homeostasis in UC,showcasing great potential for clinical applications.
文摘A 35-year-old man was admitted due to bloody stool and anemia. The bleeding source could not be detected by esophagogastroduodenoscopy or colonoscopy. Double balloon endoscopy (DBE) revealed a diverticulum-like hole in which coagula stuck in the ileum at 1 meter on the oral side from the ileocecal valve. The adjacent mucosa just to the oral side of the hole was elevated like a submucosal tumor. The lesion was considered the source of bleeding and removed surgically. It was determined to be a cyst with an ileal structure on the mesenteric aspect accompanying gastric mucosa. The diagnosis was a duplication cyst of the ileum,which is a rare entity that can cause gastrointestinal bleeding. In the present case,DBE was used to fi nd the hemorrhagic duplication cyst in the ileum.
文摘Radiotherapy is an essential method in the comprehensive treatment of malignant tumors.However,radiation proctitis(RP)is a common complication of pelvic tumors after radiotherapy.Due to RP's various etiology and complex pathogenesis,it is currently no standard for traditional Chinese medicine(TCM)treatment.Professor Yuan-hong Zhao believes that refractory RP,which is named chronic hemorrhagic radiation proctitis(CHRP),should be classified as"Intestinal Wind Bleeding"(Bleeding like a note before defecation,bright red blood,no swelling and pain in the anus)and"Intestinal Afflux"(Refers to the symptoms of pus and blood in the lower mucus,similar to ulcerative colitis,peptic ulcer and other diseases in modern medicine.)in TCM.The critical pathogenesis of CHRP lies in local stasis and collaterals injury of intestinal collaterals.In general,it is a syndrome of excess and scarcity.External treatment with TCM is the preferred treatment strategy for CHRP,and the primary way is to disperse blood stasis and detoxify and nourish the intestinal collaterals.
文摘The small intestine is an uncommon site of gastro-intestinal(GI)bleeding;however it is the commonest cause of obscure GI bleeding.It may require multiple blood transfusions,diagnostic procedures and repeated hospitalizations.Angiodysplasia is the commonest cause of obscure GI bleeding,particularly in the elderly.Inflammatory lesions and tumours are the usual causes of small intestinal bleeding in younger patients.Capsule endoscopy and deep enteroscopy have improved our ability to investigate small bowel bleeds.Deep enteroscopy has also an added advantage of therapeutic potential.Computed tomography is helpful in identifying extra-intestinal lesions.In cases of difficult diagnosis,surgery and intra-operative enteroscopy can help with diagnosis and management.The treatment is dependent upon the aetiology of the bleed.An overt bleed requires aggressive resuscitation and immediate localisation of the lesion for institution of appropriate therapy.Small bowel bleeding can be managed by conservative,radiological,pharmacological,endoscopic and surgical methods,depending upon indications,expertise and availability.Some patients,especially those with multiple vascular lesions,can re-bleed even after appropriate treatment and pose difficult challenge to the treating physician.
