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Diagnosis and treatment of small intestinal bleeding:Retrospective analysis of 76 cases

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World Journal of Gastroenterology 2006年第45期12卷 7371-7374页

作者： Ming-Chen Ba San-Hua Qing Xiang-Cheng Huang Ying Wen Guo-xin li jiang Yu Department of General Surgery Nanfang Hospital Nanfang Medical University Guangzhou 510515 Guangdong Province China

AIM: To investigate the causes of small intestinal bleed- ing as well as its diagnosis and therapeutic approaches. METHODS: A retrospective analysis was conducted ac- cording to the clinical records of 76 patients with small intestinal bleeding admitted to our hospital in the past 5 years. RESULTS: In these patients, tumor was the most fre- quent cause of small intestinal bleeding (37/76), fol- lowed by Meckel’s diverticulum (21/76), angiopathy (15/76) and ectopic pancreas (3/76). Of the 76 patients, 21 were diagnosed by digital subtraction angiography, 13 by barium and air double contrast X-ray examination of the small intestine, 11 by 99mTc-sestamibi scintigraphy of the abdominal cavity, 6 by enteroscopy of the small intestine, 21 by laparoscopic laparotomy, and 4 by ex- ploratory laparotomy. Although all the patients received surgical treatment, most of them (68/76) received part enterectomy covering the diseased segment and entero- anastomosis. The follow-up time ranged from 1 year to 5 years. No case had recurrent alimentary tract bleeding or other complications. CONCLUSION: Tumor is the major cause of small in- testinal bleeding followed by Meckel’s diverticulum and angiopathy. The main approaches to definite diagnosis of small intestinal bleeding include digital subtraction an- giography, 99mTc-sestamibi scintigraphy of the abdominal cavity, barium and air double contrast X-ray examina- tion of the small intestine, laparoscopic laparotomy or exploratory laparotomy. Part enterectomy covering the diseased segment and enteroanastomosis are the most effective treatment modalities for small intestinal bleed- ing.

关键词： Small intestine Hemorrhage Neoplasia Meckel's diverticulum

Application of laparoscopy in diagnosis and treatment of massive small intestinal bleeding: Report of 22 cases

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World Journal of Gastroenterology 2006年第43期12卷 7051-7054页

作者： Ming-Chen Ba San-Hua Qing Xiang-Cheng Huang Ying Wen Guo-xin li jiang Yu Department of General Surgery Nanfang Hospital Nanfang Medical University Ouangzhou510515 Guangdong Province China

AIM: To investigate the diagnostic and therapeutic value of laparoscopy in patients with massive small intestinal bleeding. METHODS: Twenty-two patients with massive small in- testinal bleeding and hemodynamic alteration underwent laparoscopic laparotomy in our unit from December 2002 to April 2005. Post pathologic sites were found, laparos- copy- or laparoscopy-assisted part small intestinal resec- tion including pathologic intestinal site and enteroanas- tomosis was performed in all these patients. RESULTS: The bleeding sites were successfully detected by laparoscopy in all these 22 patients. Massive small intestinal bleeding was caused by jejunum benign stromal tumor in 8 cases, by jejunum potential malignant stromal tumor in 5 cases, by jejunum malignant stromal tumor in 1 case, by Mechel’s diverticulum in 5 cases, by small intestinal vascular deformity in 2 cases, and by ectopic pancreas in 1 case. A total of 16 patients underwent laparoscopy-assisted enterectomy and enteroanastomosis of small intestine covering the diseased segment and 6 patients received enterectomy of the diseased segment under laparoscope. No surgical complications occurred and the outcome was satisfactory. CONCLUSION: Laparoscopy in diagnosis and treatment of massive small intestinal bleeding is noninvasive with less pain, short recovery time and definite therapeutic efficacy.

关键词： Small intestine Bleeding Laparoscopy Meckel's diverticulum Stromal tumor

Tumor suppress genes screening analysis on 4q in sporadic colorectal carcinoma

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World Journal of Gastroenterology 2008年第36期14卷 5606-5611页

作者： li-xin jiang Jie Xu Zhao-Wen Wang Da-Peng li Zhi-Hai Peng Jian-Jun Gao lin He Hai-Tao Zheng Department of AbdomenSurgery Department the Affiliated Yantai YuhuangdingHospital of Qingdao University Medical College Yantai264000 Shandong Province China Department ofGeneral Surgery the Affiliated Shanghai First People Hospitalof Shanghai Jiaotong University Shanghai 200080 China Shanghai Bio-x Center ShanghaiJiaotong University Shanghai 200031 China

AIM: To search candidate tumor suppressor genes (TSGs) on chromosome 4q through detecting high loss of heterozygosity (LOH) regions in sporadic colorectal carcinoma in Chinese patients. METHODS: Thirteen fluorescent labeled polymorphic microsatellite markers were analyzed in 83 cases of colorectal carcinoma and matched normal tissue DNA by polymerase chain reaction (PCR). PCR products were eletrophoresed on an ABI 377 DNA sequencer. Genescan 3.7 and Genotype 3.7 software were used for LOH scanning and analysis. Comparison between LOH frequency and clinicopathological factors were performed by χ2 test. RESULTS: Data were collected on all informative loci. The average LOH frequency on 4q was 28.56%. The D4S2915 locus showed highest LOH frequency (36.17%). Two obvious deletion regions were detected: one between D4S3000 and D4S2915 locus (4q12-21.1), another flanked by D4S407 and D4S2939 locus (4q25-31.1). None case showed complete deletion of 4q, most cases displayed interstitial deletion pattern solely. Furthermore, compared with clinicopathological features, a significant relationship was observed between LOH frequencies on D4S3018locus. In tumors larger than 5 cm in diameter, LOH frequency was significantly higher than tumors that were less than 5 cm (56% vs 13.79%, P = 0.01). On D4S1534 locus, LOH was significantly associated with liver metastasis (80% vs 17.25%, P = 0.012). No relationship was detected on other locus compared with clinicopathologial features. CONCLUSION: By high resolution deletion mapping, two high frequency regions of LOH (4q12-21.1 and 4q25-31.1) were detected, which may contribute to locate TSGs on chromosome 4q involved in carcinogenesis and progression of sporadic colorectal carcinoma.

关键词： Loss of heterozygosity Colorectal carcinoma, Chromosome 4q Tumor suppressor gene

Clinical features,diagnosis,and treatment of Peutz-Jeghers syndrome:Experience with 566 Chinese cases

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World Journal of Gastroenterology 2023年第10期29卷 1627-1637页

作者： Zu-xin Xu li-xin jiang Yu-Rui Chen Yu-Hui Zhang Zhi Zhang Peng-Fei Yu Zhi-Wei Dong Hai-Rui Yang Guo-li Gu Fifth Clinical College of Anhui Medical University Air Force Clinical College of Anhui Medical UniversityBeijing 100142China Air Force Clinical College of China Medical University Beijing 100142China Department of General Surgery Air Force Medical CenterChinese People's Liberation ArmyBeijing 100142China

BACKGROUND Peutz-Jeghers syndrome(PJS)is a clinically rare disease with pigmented spots on the lips and mucous membranes and extremities,scattered gastrointestinal polyps,and susceptibility to tumors as clinical *** preventive and curative methods are still *** we summarize our experience with 566 Chinese patients with PJS from a Chinese medical center with regard to the clinical features,diagnosis,and *** To explore the clinical features,diagnosis,and treatment of PJS in a Chinese medical *** The diagnosis and treatment information of 566 cases of PJS admitted to the Air Force Medical Center from January 1994 to October 2022 was summarized.A clinical database was established covering age,gender,ethnicity,family history,age at first treatment,time and sequence of appearance of mucocutaneous pigmentation,polyp distribution,quantity,and diameter,frequency of hospitalization,fre-quency of surgical operations,*** clinical data was retrospectively analyzed using SPSS 26.0 software,with P<0.05 considered statistically *** Of all the patients included,55.3%were male and 44.7%were *** time to the appearance of mucocutaneous pigmentation was 2 years,and median time from the appearance of mucocutaneous pigmentation to the occurrence of abdominal symptoms was 10 *** vast majority(92.2%)of patients underwent small bowel endoscopy and treatment,with 2.3%having serious *** was a statistically significant difference in the number of enteroscopies between patients with and without canceration(P=0.004,Z=-2.882);71.2%of patients underwent surgical operation,75.6%of patients underwent surgical operation before the age of 35 years,and there was a statistically significant difference in the frequency of surgical operations between patients with and without cancer(P=0.000,Z=-5.127).At 40 years of age,the cumulative risk of intussusception in PJS was approximately 72.0%,and at 50 years,t

关键词： Peutz-Jeghers syndrome Management Intussusception Canceration STK11

Peutz-Jeghers syndrome without STK11 mutation may correlate with less severe clinical manifestations in Chinese patients

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World Journal of Gastroenterology 2023年第21期29卷 3302-3317页

作者： li-xin jiang Yu-Rui Chen Zu-xin Xu Yu-Hui Zhang Zhi Zhang Peng-Fei Yu Zhi-Wei Dong Hai-Rui Yang Guo-li Gu Air Force Clinical College of China Medical University Beijing 100142China Fifth Clinical College(Air Force Clinical College)of Anhui Medical University Beijing 100142China Department of General Surgery Air Force Medical CenterChinese People's Liberation ArmyFifth Clinical(Air Force Clinical College)of China Medical UniversityBeijing 100142China

BACKGROUND Peutz-Jeghers syndrome(PJS) is an autosomal dominant genetic disease with skin mucosal pigment spots and gastrointestinal(GI) multiple hamartoma polyps as clinical characteristics. At present, it is considered that the germline mutation of STK11 gene is the genetic cause of PJS. However, not all PJS patients can be detected STK11 germline mutations. The specific clinical characteristics of these PJS patients without STK11 mutation is an interesting clinical question. Or, like wild type GI stromal tumor, whether these PJS without STK11 mutation are also called PJS is worth discussing. Therefore, we designed the study to understand the clinical characteristics of these PJS patients without STK11 *** To investigates whether PJS patients with known STK11 mutations have a more severe spectrum of clinical phenotypes compared to those *** A total of 92 patients with PJS admitted to the Air Force Medical Center from 2010 to 2022 were randomly selected for study. Genomic DNA samples were extracted from peripheral blood samples, and pathogenic germline mutations of STK11 were detected by high-throughput next-generation gene sequencing. Clinicalpathologic manifestations of patients with and without STK11/LKB1 mutations were *** STK11 germline mutations were observed in 73 patients with PJS. Among 19 patients with no detectable STK11 mutations, six had no pathogenic germline mutations of other genes, while 13 had other genetic mutations. Compared with PJS patients with STK11 mutations, those without tended to be older at the age of initial treatment, age of first intussusception and age of initial surgery. They also had a lower number of total hospitalizations relating to intussusception or intestinal obstruction, and a lower load of small intestine *** PJS patients without STK11 mutations might have less severe clinical-pathologic manifestations than those with.

关键词： Peutz-Jeghers syndrome STK11 Mutant type Wild type

Clinical features of coronary artery ectasia in the elderly

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Journal of Geriatric Cardiology 2014年第3期11卷 185-191页

作者： Qiao-Juan HUANG Yan ZHANG Xiao-lin li Sha li Yuan-lin GUO Cheng-Gang ZHU Rui-Xia XU li-xin jiang Meng-Hua CHEN Jian-Jun li Division of Dyslipidemia State Key Laboratory of Cardiovascular Disease Fu Wai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences Peking Union Medical College BeiLiShi Road 167 Beijing 100037 China Department of Cardiology Institute of Cardiovascular Diseases the First Affiliated Hospital Guangxi Medical University Nanning Guangxi 530021 China

Objective To investigate the incidence, imaging and clinical characteristics in elderly patients with coronary artery ectasia （CAE）. Methods A retrospective analysis was conducted on patients with CAE who underwent coronary angiography between January 2006 and December 2012. According to age, the enrolled patients were divided into two groups （elderly group, age≥ 65 years; non-elderly group, age 〈 65 years）. The clinical feature, imaging characteristics and the 5-year survival rate of the two groups were *** The preva-lence of CAE in elderly patients was 0.33%. Patients in elderly group were found to have significantly higher proportion of female （30.1%vs. 10.1%,P〈 0.001）, three-vessel disease （60.5%vs. 45.2%,P = 0.003） and localized ectasia （55.0%vs. 40.2%,P = 0.003）. In addition, body mass index （20.90 ± 2.71 kg/m2vs. 22.31 ± 2.98 kg/m2,P 〈 0.001） and percentage of current smokers （45.0%vs. 64.6%,P 〈 0.001） were significantly lower in elderly group. Cumulative survival curves demonstrated reduced 5-year cumulative survival at the follow-up in the elderly group compared with the non-elderly group （88.0%vs. 96.0%,P = 0.002）. But the 5-year event free survival rate failed to show a significant difference between the two groups （31.0%vs. 35.0%,P= 0.311）.ConclusionThe prevalence of CAE in elderly patients was 0.33%, which was about 1/3 of the entire numbers of CAE patients. There were significant differences between the elderly and the non-elderly patients with CAE in terms of coronary artery disease risk factors and coronary artery ectatic characteristics. CAE might be asso-ciated with increased mortality risk in the elderly.

关键词： Coronary artery ectasia Elderly patients Clinical feature

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Progress in Natural Science:Materials International 2005年第12期15卷 1110-1116页

作者： liU Gang,li xin,jiang Weimei and li Min Department of Atmospheric Sciences,Nanjing University,Nanjing 210093,China Beijing Municipal Environmental Protection Bureau,Beijing 100044,China Department of Atmospheric Sciences Nanjing University Nanjing 210093 China Beijing Municipal Environmental Protection Bureau Beijing 100044 China

The S-L (She and Leveque) scaling law,also named the hierarchical similarity theory,has been extensively tested for the turbulence made in the laboratory,but seldom been tested for the turbulence in the atmospheric boundary layer (ABL).In this paper, the S-L scaling law is applied to the turbulence in the ABL observed under unstably stratified conditions and over different types of underlying *** results of analyses show that over this type of homogeneous and flat underlying surface,such as the underlying surface in HUBEX (Huaihe River Basin Energy and Water Cycle Experiment),vertical speed and temperature fields well satisfy the S-L scaling *** the turbulence over the homogeneous but rather rough underlying surface of forest and under unstably stratified conditions in PFRD (Park Falls Ranger District of the Chequamegon National Forest,Wisconsin,USA),the analyses show that the vertical speed and temperature fields sometimes conform sometimes do not conform to the S-L scaling ***,at a time,either both of the vertical speed and temperature fields conform to the S-L scaling law,or both of them do *** speed fields in both of the field experiments do not satisfy the S-L scaling *** new explanation of the above-mentioned phenomena is given.

关键词： atmospheric turbulence Reynolds number S-L scaling law in the atmospheric turbulence boundary layer processes nonlinear dynamics

Are there tumor suppressor genes on chromosome 4p in sporadic colorectal carcinoma?

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World Journal of Gastroenterology 2008年第1期14卷 90-94页

作者： Hai-Tao Zheng li-xin jiang Zhong-Chuan Lv Da-Peng li Chong-Zhi Zhou Jian-Jun Gao lin He Zhi-Hai Peng Departmentof Abdominal Surgery The Affiliated Yantai YuhuangdingHospital of Qingdao University Medical College Yantai 264000Shangdong Province China Department ofGeneral Surgery The Affiliated Shanghai First People's Hospitalof Shanghai Jiaotong University Shanghai 200080 China Shanghai Bio-X Center ShanghaiJiaotong University Shanghai 200031 China

AIM: To study the candidate tumor suppressor genes (TSG) on chromosome 4p by detecting the high frequency of loss of heterozygosity (LOH) in sporadic colorectal carcinoma in Chinese ***: Seven fluorescent labeled polymorphic microsatellite markers were analyzed in 83 cases of colorectal carcinoma and matched normal tissue DNA by PCR. PCR products were eletrophoresed on an ABI 377 DNA sequencer. Genescan 3.7 and Genotype 3.7 software were used for LOH scanning and analysis. The same procedure was performed by the other six microsatellite markers spanning D4S3013 locus to make further detailed deletion mapping. Comparison between LOH frequency and clinicopathological factors was performed by χ2 ***: Data were collected from all informative loci. The average LOH frequency on 4p was 24.25%, and 42.3% and 35.62% on D4S405 and D4S3013 locus, respectively. Adjacent markers of D4S3013 displayed a low LOH frequency (linicopathologial ***: By deletion mapping, two obvious high frequency LOH regions spanning D4S3013 (4p15.2) and D4S405 (4p14) locus are detected. Candidate TSG, which is involved in carcinogenesis and progression of sporadic colorectal carcinoma on chromosome 4p, may be located between D4S3017 and D4S2933 (about 1.7 cm).

关键词： Loss of heterozygosity Colorectal carcinoma Chromosome 4p Tumor suppressor gene

Supraclavicular lymph node metastases from malignant gastrointestinal stromal tumor of the jejunum: A case report with review of the literature

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World Journal of Gastroenterology 2017年第10期23卷 1920-1924页

作者： Chi Ma Shao-Long Hao xin-Cheng liu Jin-Yao Nin Guo-Chang Wu li-xin jiang Alessandro Fancellu Alberto Porcu Hai-Tao Zheng Department of Gastrointestinal and Thyroid Surgery Yuhuangding Hospital Affiliated to Qingdao University Qingdao University Medical College Unit of General Surgery Department of Clinical and Experimental Medicine University of Sassari

Gastrointestinal stromal tumors(GISTs) represent the most common mesenchymal tumors of the alimentary tract. These tumors may have different clinical and biological behaviors. Malignant forms usually spread via a hematogenous route, and lymph node metastases rarely occur. Herein, we report a patient with a jejunal GIST who developed supraclavicular lymph node metastasis. We conclude that lymphatic diffusion via the mediastinal lymphatic station to the supraclavicular lymph nodes can be a potential metastatic route for GISTs.

关键词： Gastrointestinal stromal tumor Metastasis Lymph nodes