Diffuse telangiectasia of the colon: A case report

RATIONALE

Colonic telangiectasia, also known as colonic angiodysplasia, refers to arteriovenous malformations that occur in the colon, which are common vascular lesions in the GI tract.

PATIENT CONCERNS

We report a patient, who was admitted to our hospital for colonoscopy.

DIAGNOSES

Under a microscope, all the segments of the whole colon and the varicose veins showed multiple flaky spider-like telangiectasia changes. The blood vessels were radially distributed and converged in the center. The largest blood vessel was about 10 mm in diameter and had a smooth surface with no ulcers, erosion, or bleeding.

INTERVENTIONS

It was recommended that the patient undergo a capsule endoscopy to examine small intestine.

OUTCOMES

The patient did not agree to endoscopy for personal reasons. During the follow-up half a year later, the patient had no melena with normal range of hemoglobin and red blood cell counts. The fecal occult blood test came out negative.

LESSONS

While the etiology of colonic telangiectasia remains unclear, it is common in the elderly, and is more associated with geriatric conditions and diseases, especially atherosclerotic diseases. Patients who are diagnosed with colonic telangiectasia but are asymptomatic, do not need further treatment. It is usually recommended to monitor the color of stool and check the hemoglobin and fecal occult blood regularly. Colonoscopy is the main method of diagnosis of colonic telangiectasia, and the positive rate is greater than 90%. This procedure should be performed when there is no bleeding or a small amount of bleeding.

[Application research on carotid arterial shunting during simultaneous coronary artery bypass grafting and carotid endarterectomy]

Objective: The optimal operative strategy in patients with asymptomatic severe carotid artery stenosis undergoing coronary artery bypass grafting (CABG) is unknown. We sought to investigate the safety of carotid arterial shunting during simultaneous CABG and carotid endarterectomy (CEA). Methods: The clinical data of patients undergoing synchronous combined CEA and CABG in the First Hospital of China Medical University between March 2017 and July 2019 was retrospectively studied. Patients with asymptomatic severe carotid artery stenosis ≥70% according to NASCET (North American Symptomatic Carotid Endarterectomy Trial) were required CABG surgery. During conventional CEA, carotid arterial shunting was used in all cases. Results: Ten patients were recruited. The average clamping time of carotid artery was 5 minutes. The average follow-up time was 10 months. We did not observe stroke, cerebral hyper perfusion syndrome, death and carotid restenosis. Conclusions: Carotid arterial shunting during synchronous combined CEA and CABG was helpful for obtaining good curative effect.

In situ TEM observation of buffering the anode volume change by using NiTi alloy during electrochemical lithiation/delithiation

A novel Ti3Sn/NiTi shape memory alloy anode with a sandwich structure was fabricated by arc melting. In order to characterize in situ the Ti3Sn/NiTi anode microstructure changes and phase transformations during cycling, a nanoscale lithium battery was set up inside a transmission electron microscope, which consists of Li metal as the cathode, the native Li2O layer on the surface of Li metal as the solid electrolyte, and the Ti3Sn/NiTi as the anode. Only the Ti3Sn intermetallic compound experienced the electrochemical reaction, while the NiTi alloy (inactive with Li(+)) was applied for buffering the Ti3Sn volume change during cycling. An obvious reaction front of Ti3Sn migrated from one end to the other during lithiation, which can also return after delithiation. It provides direct evidence that the NiTi alloy can effectively accommodate the anode volume change during electrochemical lithiation and delithiation.

[Effect of low molecular weight heparin on unstable angina]

OBJECTIVE

To evaluate the effect of low molecular weight heparin (LMWH) and verus urokinase (UK) on unstable angina (UA).

METHODS

Sixty seven patients with UA were divided in two groups by a single blind, controlled, randomized method: LMWH (anti-thrombi) group and UK (thromblytic therapy) group. Total ischemia load in 24 hours ambulatory ECG, mortality and cases of acute myocardial infarction (AMI) in 30 days were employed to compare the effect and safety between two groups.

RESULTS

There was no significant difference in decreasing attacks of angina pectoris and total ischemia load between two groups. The UK group had two cases of AMI and five cases of complications of bleeding (two cases of epistaxis, two cases of bleeding gums, one case of hematochezia).

CONCLUSION

Antithrombin therapy is prior to thromblitic therapy, treatment of LMWH is safer than that of low dose UK in UA.

[Clinical features of acute myocardial infarction in the young and middle-aged patients: analysis of 68 cases of coronary artery angiography]

OBJECTIVE

This study was to evaluate the clinical features of acute myocardial infarction (AMI) in young and middle-aged patients.

METHODS

Eighty-seven patients were classified into two groups according to the age. Among them, 61 patients were 60 years old and above, 26 patients below 50 year old. Selective coronary artery angiography was performed on 68 cases and a scoring method which reflects the extent of narrowing of coronary artery was also used.

RESULTS

The older group had more risk factors than the young group. The angina pectoris in the young group was less than the older group. The incidence of acute heart failure in the young group was higher than the older group. The mortality of both two groups had no significant differences.

CONCLUSION

The high risk of AMI in the young and middle-aged patients should be paid more attention in the clinic.