脊柱关节病骶髂关节的病理表现

目的 了解不同阶段骶髂关节（SIJ）炎的病理变化,提高脊柱关节病（SpA)的早期诊断水平。方法 8例强直性脊柱炎（AS）及5例未分化脊柱关节病（uSpA)患者行CT导引下SIJ关节内激素治疗前,先取SIJ组织。所得标本行HE染色,普通光学显微镜观察。结果 CT0－I级SIJ炎的uSpA病人,SIJ可见滑膜炎症（包括衬里层细胞肥大增生、疏松结缔组织炎症细胞浸润）,局灶性软骨基质减少、变性、纤维化,软骨下骨板炎症细胞浸润。CTⅡ-Ⅲ级SIJ炎病理变化主要为软骨严重变性、破坏,血管翳形成,大量炎症细胞浸润,软骨下骨板破坏;CTⅣ级SIJ炎的病理改变则以软骨下骨板破坏,大量死骨形成,钙盐沉着为主要特点。3份标本的滑膜和软骨下骨板可见嗜酸性粒细胞（EO）比例增高。结论 滑膜衬里细胞肥大增生、疏松结缔组织炎症细胞浸润等滑膜炎表现,局灶性软骨基质减少、变性、纤维化和软骨下骨板炎症细胞浸润、破坏,是早期SIJ炎的病理特点;在CT未出现改变以前,病理学检查有助于早期诊断。     

脊柱关节病患者骶髂关节细针活检的病理表现及其临床意义

目的了解骶髂关节(SIJ)炎的病理表现,提高强直性脊柱炎(AS)的早期诊断水平。方法对96例脊柱关节病(SpA)患者的SIJ进行CT导引下的细针活检,3例非SpA死亡病例为对照组。记录临床资料进行分析。结果76例SpA的SIJ存在炎症表现,包括骨髓炎、血管翳形成和炎性细胞浸润,软骨下骨板破坏,软骨变性、破坏,滑膜炎,附着点炎等。其中45例0～Ⅰ级CT下SIJ炎均存在骨髓炎、软骨下骨板炎、软骨变性等改变;0级CT下SIJ炎的滑膜无病理改变,而部分Ⅰ级和所有≥Ⅱ级SIJ炎滑膜可见炎症;软骨破坏和骨化发生率以0～Ⅰ级最低,且仅见于软骨下骨板侧,关节面侧未见破坏;骨质硬化也是0～Ⅰ级最少见;附着点炎仅见于部分≥Ⅱ级SIJ炎;炎性细胞浸润程度Ⅳ级最低。45例0～Ⅰ级CT下SIJ炎的SpA经病理检查诊断为AS;其平均病程显著短于≥Ⅱ级者。结论0级CT下SIJ炎时SIJ已可有炎症存在。SIJ炎可能自骨髓开始,继而血管翳形成,软骨下骨板破坏,软骨变性、破坏,最后纤维化、骨化而导致关节融合。滑膜炎和附着点炎不是SIJ炎的最早改变。病理检查有利于AS的早期诊断和鉴别诊断。     

骶髂关节病变病理学与影像学诊断的相关性

目的通过了解骶髂关节炎病理特点,并以病理结果为标准,探讨病理表现与放射性核素单光子发射计算机断层成像术(single-photon emission computed tomography,SPECT)、磁共振显像(magnetic resonance imaging,MRI)、计算机断层扫描(computed tomography,CT)、X线等影像学检查的关系。方法对中轴型脊柱关节炎患者进行CT引导下骶髂关节(sacroiliac joint,SIJ)穿刺,所得组织进行病理检查,并同时行SIJ的SPECT、MRI、CT和X线检查,按组织病理结果分为SIJ炎组和无炎性反应组。结果 36例患者获得组织有软骨、软骨下骨板、关节滑膜、骨髓、肌腱或韧带附着点等。获得率以软骨为最高,继以软骨下骨板、关节滑膜、骨髓和韧带附着点,各占92%、83%、75%、72%、22%;其中28例(2836,78%)患者SIJ炎病理变化包括软骨(93%)和软骨下骨板改变(75%)、滑膜炎(64%)、骨髓炎(46%)、附着点炎(32%),8例(22%)未发现有SIJ炎改变。MRI示29例(81%)患者共56个SIJ可见不同程度的异常信号改变,软骨线改变、软骨下骨板改变、骨髓水肿、脂肪沉积、骨质硬化分别为82%、71%、65%、59%、76%;SPECT示29例(81%)共52个SIJ可见骶髂关节感兴趣区的放射性比值有不同程度的升高,23例(64%)CT阳性,19例(53%)X线阳性。以病理结果为标准,SPECT、MRI、CT、X线的阳性预测值分别为89.6%、93.1%、95.6%、94.7%,敏感性分别为92.8%、96.4%、73.3%、64.2%,特异性分别62.5%、75.0%、87.5%、87.5%。4种诊断方法的受试者工作特征曲线下面积分别为0.79、0.84、0.83、0.76。结论病理检查是诊断Sl J炎和活动性炎性反应的主要方法。MRI和SPECT的相互补充,能提高骶髂关节活动性炎症的敏感性和特异性。MRI和SPECT的诊断价值与CT和X线相当,并可通过对炎症的活动度进行量化,有利于随访和疗效的评价,是诊断SIJ炎重要的辅助手段。     

早期骶髂关节炎和致密性髂骨炎的鉴别(附33例临床分析)

目的了解早期骶髂关节(SIJ)炎和致密性髂骨炎(OCI)的鉴别诊断要点。方法对1997~2004年汕头大学医学院第一附属医院经X线诊断的33例OCI全部进行SIJCT扫描,CT未能确诊的病例进行SIJ细针穿刺活检。记录临床、实验室、影像学、病理检查资料,进行分析。结果33例中,17例经CT或病理检查证实SIJ炎症。这些病例的临床特点包括:(1)80%以上HLA-B27阳性。(2)年龄较OCI病例轻。(3)有1/3左右病例为男性,女性多为未婚或未育者。(4)临床上都有SIJ炎的症状和(或)体征。(5)实验室检查多有γ球蛋白、血沉(ESR)、C反应蛋白(CRP)、碱性磷酸酶(ALT)升高。而OCI病例HLA-B27阳性率同一般人群,均为女性,且多为经产妇,少有SIJ炎体征或实验室检查异常。结论X线OCI中,不少病例可能是早期SIJ炎,应注意深入检查以除外之。     

早期骶髂关节炎和致密性髂骨炎的鉴别（附33例临床分析）

目的 了解早期骶髂关节（SLI）炎和致密性髂骨炎（OCI）的鉴别诊断要点。方法 对1997～2004年汕头大学医学院第一附属医院经X线诊断的33例OCI全部进行SUCT扫描，CT未能确诊的病例进行SU细针穿刺活栓。记录临床、实验室、影像学、病理检查资料，进行分析。结果 33例中，17例经CT或病理检查证实SU炎症。这些病例的临床特点包括：（1）80％以上HLA—B27阳性。（2）年龄较OCI病例轻。（3）有1／3左右病例为男性，女性多为未婚或未育者。（4）临床上都有SU炎的症状和（或）体征。（5）实验室检查多有1球蛋白、血沉（ESR）、C反应蛋白（CRP）、碱性磷酸酶（ALT）升高。而OCI病例HLA—B27阳性率同一般人群，均为女性，且多为经产妇，少有SLI炎体征或实验室检查异常。结论 X线OCI中，不少病例可能是早期SU炎，应注意深入检查以除外之。     

强直性脊柱炎骶髂关节内皮质激素注射疗效观察

目的了解强直性脊柱炎(AS)骶髂关节(SIJ)内皮质激素注射的疗效.方法患者取俯卧位,在CT导引下穿刺SIJ滑膜部,取组织标本后,在CT导引下原路进入SIJ,每侧注入丙酮缩去炎舒松15mg.记录分析病人术前、术后临床资料.结果28例中22例(78.6%)疼痛明显减轻,晨僵、夜间痛、SIJ压痛、"4”征、ESR升高及需使用NSAIDs的例数均较术前明显减少.所有SIJ标本均有炎症表现.结论SIJ关节内注射长效激素,可作为对NSAIDs不耐受或无效的AS和uSpA病人的一种有效的缓解腰背痛手段,同时uSpA病人SIJ病理标本的获得,有助于早期诊断.     

强直性脊柱炎骶髂关节病变的CT诊断价值

目的 探讨CT扫描对强直性脊柱炎（AS）骶髂关节病变的诊断价值及年龄特征对CT表现的影响。方法 收集780例根据临床表现和／或实验室检查疑诊AS,并且骶髂关节的X线及CT资料完整者为研究对象。分别参照X线及CT片对其进行了分级和征象统计,并以＜40岁（第1组513例）和≥40岁（第2组267例）将其分为两组,进行分级及CT表现差异的比较。结果 本组X线诊断为0－Ⅳ级骶髂关节病变的各组中,CT结果与之符合的比率分别为44％、35％、49％、71％和77％。根据CT所示可以分别将56％、29％、33％X线平片诊断正常及Ⅰ、Ⅱ级病变的病例提高1－2个诊断级别。第1组0－Ⅰ组所占比率明显高于第2组,而Ⅱ组比率则远低于第2组。第1组骨性关节面硬化、模糊的发生率明显低于第2组。结论 CT扫描对AS骶髂关节病变的诊断具有重要价值。CT与平片的区别在于细微征象的显示率高,对较早期的病变可以提高诊断等级,同时也有利于治疗析观察。本研究的分组分析结果提示在对骶髂关节的CT片进行分析时亦应将年龄因素导致的退行性表现考虑在内。     

影像学检查在强直性脊柱炎诊断中的价值

强直性脊柱炎（ankylosing spondylitis,AS）是一种好发于青少年、病因不明且进展缓慢的慢性炎性疾病,AS患者可出现包括骶髂关节炎、周围关节炎、肠病性关节炎、肌腱韧带及关节囊附着点炎等多种症状,病变多从骶髂关节（sacroiliac joint,SIJ）开始,自下而上发展,沿脊柱进行性上升,逐渐形成脊柱关节炎,最终导致关节纤维性、骨性强直。     

结缔组织生长因子及I型和Ⅲ型胶原在脊柱关节病骶髂关节组织中的表达

目的 了解脊柱关节病(SpA)患者骶髂关节中结缔组织生长因子(CTGF)、I型胶原、Ⅲ型胶原的表达情况,探讨CTGF在spA关节软骨纤维化、骨化、关节强直中的作用.方法 30例spA患者(17例双侧影像学骶髂关节炎≥Ⅱ级,13例影像学骶髂关节炎Ⅰ级)均接受CT引导下骶髂关节穿刺活检术,取得骶髂关节组织.组织标本均行苏木素一伊红(HE)染色确认存在骶髂关节炎后,通过免疫组织化学染色方法,标记CTGF、Ⅰ型胶原及Ⅲ型胶原的表达情况.统计学方法采用单因素方差分析和t检验.结果 30例SpA患者骶髂关节组织中CTGF主要在血管翳炎症细胞及骨髓细胞的胞质中高度表达,阳性细胞数明显多于正常组织对照组[(57.9±42.4)腐倍视野和(2.7±2.5),高倍视野);Ⅰ型胶原及Ⅲ型胶原明显沉积于骨、部分软骨及韧带,平均吸光度均明显高于对照组(分别为0.298±0.080和0.044±0.024;28.254±41.165和0.105±0.054).结论 SpA骶髂关节中存在CTGF的高表达,Ⅰ型胶原及Ⅲ型胶原的沉积增多,提示CTGF参与了SpA骶髂关节局部胶原沉积、软骨纤维化变性过程,可能在SpA关节软骨纤维化、关节强直中起重要的作用.

Abstract：

Objective To investigate the expression of connective tissue growth factor(CTGF),coll agen I and collagen Ⅲ in sacroiliac joint(SIJ)of patients with spondyloarthropathy(SpA).Methods Thirty patients with SpA,including 17 patients with grade Ⅱ saeroiliitis and 13 patients with grade Ⅰ sacroiliitis,were performed on CT guided needie biopsy of SIJ.After sacroiliitis were confirmed by staining with hematoxylin and eosin in sacroiliac joint tissue sample,immunohistochemical assay was performed to determine the expression of CTGF,collagen Ⅰ and collagen Ⅲ in sacroiliac ioint tissue.Univariate Chi-square test was used for data comparison between multiple groups and t-test was used for two group data comparison.Results Contrast to healthy controls,CTGF were found upexpressed on the cytoplasm of inflammatory cells in pannus and bone marrow of sacroiliac tissue samples of patients with SpA,while collagen I and collagen Ⅲ were found up-expressed in bone,cartilage and ligament tissue[(57.9±42.4)/HP vs(2.7±2.5)/HP P<0.05,0.298±0.080 vs 0.044±0.024 and 28.254±41.165 vs 0.105±0.054.P<0.05 respectively].Conclusion CTGF,collagen Ⅰ and collagen Ⅲ are up-expressed in SIJ of SpA patients.CTGF may play an important role in articular cartilage fibrosis and ossification of SpA.     

30例血清阴性类风湿关节炎患者3.0T MRI与DRX检查结果比较

目的提高血清阴性类风湿关节炎的诊断水平。方法对30例血清阴性类风湿关节炎患者（观察组）及30例骨关节炎患者（对照组）同时行双手3.0T MRI及直接数字成像（DR）X线检查,观察骨髓水肿、滑膜炎、骨侵蚀、肌腱炎、关节积液、骨赘形成及软组织肿胀情况。结果观察组3.0T MRI检查骨髓水肿、滑膜炎、肌腱炎及关节积液检出率显著高于对照组,DRX无法直接观察到上述征象,但软组织肿胀检出率明显高于对照组。结论 3.0T MRI在老年血清阴性类风湿关节炎诊断中的效果优于DRX,骨髓水肿、滑膜炎、关节积液及肌腱炎均是特异性检查征象。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

CagA-Hp抗体IgG与胃炎的组织学分析

研究幽门螺杆菌(Hp)感染与胃炎的关系。方法对204例慢性胃炎患者胃粘膜进行观察分析,并测定其中137例Hp阳性患者血清CagA-Hp抗体IgG水平,与组织学对照。结果慢性萎缩性胃炎伴肠上皮化生患者血清CagA抗体IgG明显高于对照组(P＜0.01);其他类型胃炎患者血清CagA抗体IgG水平无明显增高(P＞0.05)。结论CagA-Hp可能是导致慢性萎缩性胃炎伴肠上皮化生的因素之一,对这类患者应密切随访观察。     

慢阻肺急性加重期患者预后的影响因素分析

目的探讨慢性阻塞性肺病急性加重期(AECOPD)患者预后的相关危险因素。方法回顾性调查、收集58例AECOPD患者可能影响其预后的相关因素,并对其分别进行单因素分析。并进行Logistic多元逐步回归进行多因素分析,筛选影响AECOPD患者预后的独立危险因素。结果单因素分析后将结果 P0.1的因素纳入多因素Logistic回归,分析发现是否合并呼吸衰竭、气促程度、白细胞计数、APACHEⅡ、应用抗氧化剂、慢阻肺治疗依从性为影响AECOPD患者预后不佳的独立因素(P0.05)。结论根据AECOPD患者预后的独立危险因素,及早判断,选择合适的后续治疗方案,对提高其生存率及生存质量具有重要意义。     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

Results of treatment of fistula-in-ano

To evaluate the application of Parks' classification in the management of patients with fistula-in-ano, a study was undertaken to assess the outcome of surgery, especially with respect to the recurrence rate and alteration of continence. A retrospective analysis of 160 consecutive patients who were classified at the time of operation was conducted. The distribution of fistulas was as follows: intersphincteric, 41.9 percent, transsphincteric, 52.1 percent, suprasphincteric, 1.3 percent, extrasphincteric, 0. A horseshoe extension occurred in 8.8 percent of the fistulas and 3.8 percent did not exactly conform to the classification as they were either complex or combinations of more than one type of fistula. The sole immediate postoperative complication was bleeding, which occurred one week postoperatively and ceased spontaneously (0.7 percent). Alteration in continence occurred in 6 percent of patients with 2.6 percent experiencing temporary incontinence to flatus, 1.3 percent to liquid stool, and 0.7 percent to solid stool. Permanent loss of control for flatus occurred in one patient (0.7 percent) and for liquid stool in one patient (0.7 percent). No patients suffered loss of control for solid stool. Recurrence developed in 6.3 percent of patients, all between five and 25 months postoperatively. Classifcation was found to be a useful guide in the operative management of patients with fistula-in-ano. Read at the joint meeting of the American Society of Colon and Rectal Surgeons with the Section of Colo-Proctology, Royal Society of Medicine, and the Section of Colonic and Rectal Surgery, Royal Australasian College of Surgeons, New Orleans, Louisiana, May 6 to 11, 1984.     

Intake of energy drinks in association with alcoholic beverages in a cohort of students of the School of Medicine of the University of Messina

BACKGROUND: Energy drinks (ED) are a widely used group of beverages known for their stimulant effects on central nervous system (CNS). The main components of ED are caffeine, taurine, carbohydrates, glucuronolactone, inositol, niacin, pantenol, and beta-complex vitamins. The studies evaluating the effects of ED describe improvements in attention and/or reaction times and indices of alertness. It has been also shown that combination of caffeine and glucose, fundamental constituents of ED, can ameliorate deficits in cognitive performance and subjective fatigue during extended periods of cognitive demand. Moreover, the associated ingestion of alcohol and ED has recently been observed to be becoming more and more widespread. METHODS: With the aim to know the habits and uses of students, we administered a questionnaire containing questions regarding ED drinking alone or in association with alcoholic beverages. Five hundred students of the School of Medicine of the University of Messina were interviewed, and 450 filled the questionnaire. RESULTS: A total of 56.9% of students declared using ED. A great part of users (48.4%) associate frequently ED and alcohol. In particular, 35.8% of ED + alcohol users have used ED + alcohol more than 3 times in the last month. Distinguishing the users into 2 groups (users of ED + alcohol and users of both ED and ED + alcohol), we observed in the second group a major use of cocktail containing a mix of ED and alcoholic beverages. This difference between the 2 groups is less represented about the ingestion of ED + alcohol in the night. CONCLUSIONS: Our data indicate that association of ED + alcohol is very popular among students. This behavior can be dangerous. In fact, the combination of ED + alcoholic drinks can reduce adversive symptoms of alcohol intoxication including the depressant effects. As consequence, users of ED + alcoholic beverages might not feel the signs of alcohol intoxication, thus increasing the probability of accidents and/or favoring the possibility of development of alcohol dependence.