纤维结肠镜粘膜活检—炎症性肠疾病

目前对全大肠和末端回肠进行纤维结肠镜粘膜活检,已成为较常见的检查方法。通过肠粘膜活检,既能对肠道本身的疾病(如炎症、息肉和恶性肿瘤)、又能对某些全身性疾病(如淀粉样变性、结节性动脉周围炎和恶性高血压等)做出诊断。纤维结肠镜活检还可确定病变的范围和严重程度;另外,由于纤维结肠镜应用方便,可在疾病的不同阶段进行活检,从而了解疾病全过程的病理变化,发现早期     

国人远段回肠粘膜的扫描电镜观察

本研究利用纤维结肠镜,对38例受检者进行逆行性回肠观察,并将活体检查组织制成扫描电镜标本进行观察。结果表明,国人的回肠粘膜绒毛以指状为主,有些呈舌状。嵴状罕见,未见分支、融合等形状的绒毛。     

改良球囊蕈行管在低位直肠癌末段回肠造口中的应用

目的 探讨改良球囊蕈行管在低位直肠癌末段回肠造口中的临床价值.方法 20例低位直肠癌经前切除吻合后,用改良球囊蕈行管用可吸收线缝合固定于末段回肠,以防治吻合口漏.结果 未发生吻合口漏,术后二周均拔除改良球囊蕈行管,未出现并发症.结论 改良球囊蕈行管制作简单,可有效防治直肠癌术后吻合口漏,可避免再次行回肠回纳手术.     

人工智能肠镜辅助诊断技术提高结肠SSL病变检出率

目的:探究人工智能肠镜辅助诊断技术提高结肠 SSL 病变检出率的临床应用价值.方法:选取 2020年 3 月至 2022 年 9 月于我院行结肠镜检查且符合入组条件的 1000 例患者作为研究对象.随机将其分为对照组和观察组,每组各500 例.对照组行结肠镜检查;观察组在结肠镜基础上使用内镜精灵辅助检查.比较两组结肠镜检查过程中盲肠插入时间、退镜时间,及对结肠无蒂锯齿状病变(Sessile Serrated Lesion,SSL)与息肉检出情况.结果:观察组盲肠插入时间短于普通肠镜组(P＜0.05),两组退镜时间差异无统计学意义(P＞0.05).对照组有 119 例患者检出结肠息肉,观察组 194 例,观察组检出率 38.80%高于对照组 23.80%(P＜0.05).对照组检出421 枚息肉,其中大息肉278枚,小息肉143 枚;观察组检出598枚息肉,其中大息肉453枚,小息肉145枚.两组息肉大小、个数差异无统计学意义(P＞0.05).两组在检出的息肉中检出SSL 病变情况:对照组检出 SSL 共 16 例,观察组检出 43 例.观察组 SSL 病变检出率 7.19%高于对照组3.80%(P＜0.05).结论:人工智能肠镜辅助诊断技术能缩短盲肠插入时间,显著提高结肠息肉检出个数,提升结肠SSL病变检出率.     

回盲部的解剖学观测

为补充国人体质调查资料,本文对福尔马林固定的成尸61例(男44,女17)和童尸8例(其中度量项目得自成尸)的回盲部进行了选择性观测。结果如下:一、回结肠动脉结肠支与回肠支的供血范围外结肠始段由回结肠动脉的结肠支供血,结肠支与右结肠动脉降支之间形成弓形吻合,其间较细处为分界标志进行测量,得结肠支供应升结肠始段的长度为75.6±3.1mm(35.0～125.0),(均值±标准误,最小值-最大值),其中长50.0～110.0mm者较多,共54例,占88.5±4.1%;回肠末段由回结肠动脉的回肠支供血,回肠支与肠系膜上动脉回肠动脉在回肠末段形成     

结肠镜在结直肠早癌防治中的作用

目的通过对结肠息肉及结肠早癌疾病的分析,强调结肠镜在结直肠早癌的早期诊治及早期预防中的意义。方法回顾性对我院5年来832例超生结肠镜检查中所发现结肠早癌及结肠息肉病例进行分析。结果显示共检出息肉298例(占21.7%)、结肠癌58例(占5.67%),其中结肠早癌23例。结肠息肉及结肠癌均好发于直、乙状结肠。结论超生结肠镜检查能提高结肠息肉的早期干预治疗,强调结肠镜在结肠癌早期诊治的作用(有助于提高结直肠癌的防治)。     

电子结肠镜检查的护理操作体会

电子结肠镜检查已广泛应用于临床,医生、护士及病人的配合程度直接影响检查结果。从1997年～1998年笔者配合医生对拟诊“结肠炎”、“结肠肿瘤”、“便血原因待查”等疾病的165例进行电子结肠镜检查,现将护理操作体会介绍如下,与同行共同探讨。     

国人回肠粘膜的组织学研究

为了研究我国正常人的回肠粘膜组织形态,我们利用纤维结肠镜活检81例正常人的回肠粘膜,在光学显微镜下观测了粘膜厚度、绒毛高度及宽度、隐窝深度、绒毛高度与隐窝深度之比、上皮间淋巴细胞与肠上皮细胞之比,杯状细胞与肠吸收上皮细胞之比及隐窝中核分裂细胞计数等。连续切片发现淋巴滤泡可分为三型即粘膜下型、粘膜型及二者的过渡型。     

迁延性慢性腹泻病患儿回肠末端纹状缘肽酶及双糖酶活性的初步研究

目的测定迁延性慢性(迁慢性)腹泻病患儿回肠末端纹状缘肽酶及双糖酶活性水平,探讨回肠末端黏膜组织学形态与纹状缘肽酶、双糖酶活性水平的关系。方法收集结肠镜检查患儿回肠末端黏膜标本行病理学检查,以迁慢性腹泻病及非腹泻病组患儿为观察对象,两组中病理学检查为慢性炎症者为慢性炎症组,余为黏膜正常组。非腹泻病组中病理学检查结果正常者为对照组,测定回肠末端黏膜标本中纹状缘肽酶和双糖酶活性水平。结果2007年7月至2008年3月在广州医学院附属广州市儿童医院共收集到27例回肠黏膜标本,光镜下见其绒毛形态均正常,病理学检查10/27(37.0%)例有慢性炎症。迁慢性腹泻病组纹状缘肽酶及双糖酶活性水平与对照组差异均无统计学意义(P>0.05),慢性炎症组纹状缘肽酶及双糖酶活性水平与黏膜正常组差异均无统计学意义(P>0.05)。结论回肠末端黏膜绒毛正常的迁慢性腹泻病患儿,其纹状缘肽酶及双糖酶活性水平无明显变化。慢性炎症且绒毛正常的回肠末端黏膜,其纹状缘肽酶活性及双糖酶无明显变化。     

62821例男性婚前医学检查浅析

目的通过17年来共62821例男性婚前医学检查的分析,探讨婚前保健工作对优生的重要性及如何开展自愿进行婚前医学检查工作。方法对一方户口在厦门岛内的待婚男女青年,根据相关规定进行婚前医学检查及特殊项目检查。结果62821例男性婚前医学检查中检出疾病及异常情况6708例;检出率最高年份为12.34%、最低年份为8.81%、平均检出率10.67%;检出传染病309例,检出率0.49%;其中性传播疾病202例,检出率0.32%;有关精神病2例,检出率0.32%;遗传性疾病102例,检出率0.16%;检出重要的特殊病例有白化病、麻风、两性畸形、肌营养不良等;疾病检出率最高按顺位排列依次为包皮过长13.48%、精索静脉曲张1.47%、高度近视1.41%、包茎0.75%、斜疝0.32%。结论维持高婚检率是有效发现和控制影响婚育主要疾病和重要异常情况的前提,影响婚育的疾病可直接影响双方和下一代的健康以及恋爱婚姻家庭的稳定性。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The case for allele‐specific recognition by the TCR

There is a sharp difference in how one views TCR structure–function–behaviour dependent on whether its recognition of major histocompatibility complex‐encoded restriction elements (R) is germline selected or somatically generated. The generally accepted or Standard model is built on the assumption that recognition of R is by the V regions of the αβ TCR, which is not driven by allele specificity, whereas the competing model posits that recognition of R is allele‐specific. The establishing of allele‐specific recognition of R by the TCR would rule out the Standard model and clear the road to a consideration of a competing construct, the Tritope model. Here, the case for allele‐specific recognition (germline selected) is detailed making it obvious that the Standard model is untenable.