十二指肠炎的胃镜诊断

目前对十二指肠炎的认识和看法仍有分岐,其命名也比较混乱,有单纯性十二指肠炎、消化性十二指肠炎、慢性非特异性十二指肠炎、十二指肠球炎、慢性十二指肠炎、原发性十二指肠炎和原因未明的十二指肠炎等。十二指肠炎一般多指慢性原发性非特异性十二指肠炎而言。其诊断标准是,经内镜检查在直视下     

原发性淋巴细胞性垂体炎合并Rathke裂囊肿1例报告并文献复习

<正>蝶鞍区占位主要以垂体瘤为主,垂体的炎性破坏极为少见。自身免疫性垂体炎是一种由于自身免疫反应引起的垂体炎症性疾病,临床主要表现为垂体肿大和垂体功能低下。根据其病理学表现可分为淋巴细胞性垂体炎、肉芽肿性垂体炎及黄瘤病性垂体炎等。根据其病因可分为原发性垂体炎和继发性垂体炎,原发性垂体炎主要包括病因尚不明确的垂体炎。继发性垂体炎是指有明确病因的垂体炎,其中包括由Rathke裂囊肿破裂后其内容物外渗所致     

不同致炎剂诱导大鼠硬脑膜神经源性炎症

目的观察不同致炎剂刺激大鼠硬脑膜的神经源性炎性反应,为建立慢性偏头痛模型提供实验依据。方法雄性SD大鼠24只,随机分为4组,生理盐水组、致炎剂组、降钙素基因相关肽(CGRP)组、致炎剂+CGRP组,每组6只。使用激光多普勒血流仪检测刺激前后各组硬脑膜动脉血流量,甲苯胺蓝染色观察肥大细胞脱颗粒数及脱颗粒比例,伊文思蓝荧光法观察大鼠硬脑膜血管渗出情况。结果与刺激前比较,致炎剂组、CGRP组、致炎剂+CGRP组大鼠刺激后脑血流明显增多。致炎剂+CGRP组大鼠脑血流量较生理盐水组、致炎剂组、CGRP组明显增多;致炎剂组、CGRP组、致炎剂+CGRP组大鼠硬脑膜肥大细胞脱颗粒比例较生理盐水组明显增加。致炎剂+CGRP组大鼠硬脑膜肥大细胞脱颗粒比例较致炎剂组及CGRP组明显增加。致炎剂组、CGRP组、致炎剂+CGRP组大鼠硬脑膜荧光红斑明显多于生理盐水组。结论致炎剂+CGRP较常规致炎剂、CGRP刺激大鼠硬脑膜可以引起脑血流显著增加,肥大细胞脱颗粒及血管渗出,从而发生神经源性炎性反应。     

周边部色素膜炎(附7例分析)

周边部色素膜炎系指从前房角到脉络膜周边部的炎性病变,亦称为后部睫状体炎、慢性睫状体炎、睫状体扁平部炎、周边部网     

特发性炎性肌病119例肌肉活检病理分析

目的：探讨特发性炎性肌病（IM）的肌肉活检病理类型及其临床病理联系。方法：回顾性分析IM的病理改变，归纳出各病理类型的特点，随访并评估IM患者的预后情况。结果：在119例IM中，重、中、轻度坏死性肌炎分别为11例、19例和27例，束周坏死／萎缩性肌炎20例，无炎细胞浸润的坏死性肌炎22例，间质性肌炎11例，肌筋膜炎3例，包涵体肌炎4例，肉芽肿性肌炎和增生性肌炎各1例，其中72例获得随访资料，轻度坏死性肌炎和束周坏死／萎缩性肌炎患者的好转和治愈的百分比高于中，重度坏死性肌炎患者，间质性肌炎和无炎细胞浸润的坏死性肌炎的好转和治愈百分比高于重度坏死性肌炎，结论：IM的病理类型对判断预后具有重要的参考价值。     

皮肌炎、多发性肌炎食管性吞咽困难中药治疗

目的观察中药肌炎灵胶囊与肌炎2号冲剂对皮肌炎、多发性肌炎食管性吞咽困难的治疗效果.方法皮肌炎、多发性肌炎食管性吞咽困难患者29例,应用肌炎灵胶囊(主要由丹参、绞股蓝、仙灵脾等药组成)、肌炎2号冲剂(主要由人参、白术、半夏、枳实等药组成)进行治疗,其中男8例,女21例,男女比例约为12.8,年龄16岁～65岁,平均38.4岁;3mo1疗程.治疗结束后,对患者的临床症状、X线表现的改善情况进行分析.结果经肌炎灵胶囊与肌炎2号冲剂治疗3mo后,临床显效12例,好转14例,无效3例,总有效率为89.66%.结论肌炎灵胶囊与肌炎2号冲剂对皮肌炎、多发性肌炎食管性吞咽困难有良好的治疗作用.     

急性胰腺炎促炎细胞因子和抗炎细胞因子的动态变化及其作用

目的：探讨促炎细胞因子和抗炎细胞因子在急性胰腺炎（AP）发病机制中的作用,方法：应用ELISA法检测48例病人血液中促炎细胞因子（TNF（α、IL-1β、IL-6、IL-8）和抗炎细胞因子（IL－10、IL－1ra)。结果：AP病人血液中促炎细胞因子和抗炎细胞因子在早期持续显著升高（与正常对照组相比P＜0．05）,其后逐渐下降,并与临床症状变化的时相一致。结论：促炎细胞因子和抗炎细胞因子在急性胰腺炎的发生发展过程中可能均具有重要作用。     

急性心肌梗死患者炎性因子表达与室性心律失常的关系

目的研究急性心肌梗死(AMI)患者的炎性因子水平与心梗后室性心律失常的关系。方法不同时间点检测65例AMI患者的心肌酶谱及血浆炎性因子表达水平,并监测其心律失常情况,进行相关性分析。结果血浆炎性因子水平与心肌酶谱呈正相关(P<0.05),炎性因子表达与心梗后室性早搏Lown分级呈正相关(P<0.05),前壁AMI患者炎性因子水平较其他部位高(P<0.05)。结论AMI后炎性因子表达水平与室性心律失常存在一定关系,AMI后室性心律失常发生多的患者炎性因子表达水平高。     

散发性包涵体肌炎一例报告

目的 探讨散发性包涵体肌炎临床与病理特点.方法 对1例散发性包涵体肌炎的临床表现,肌电图,肌肉活检等资料进行分析.结果 该病例根据临床表现,实验室检查,肌电图表现,肌肉病理改变确诊为散发性包涵体肌炎.结论 散发性包涵体肌炎发病机制尚未明确,临床表现缺乏特异性,肌肉病理学检查可以作为诊断散发性包涵体肌炎的金标准.     

microRNA与脂肪组织慢性低度炎性反应

脂肪组织慢性低度炎性反应是肥胖、2型糖尿病、高血压、心血管疾病等代谢性疾病的中心环节.研究脂肪组织慢性低度炎性反应的精确调控过程,对于预防和治疗肥胖及相关疾病有重要意义.microRNA是一类非编码RNA,具有调节基因表达的功能.研究显示,microRNA对脂肪组织巨噬细胞、经典炎性反应信号通路及炎性因子、抗炎因子等具有调控作用.     

Can help for patients be too expensive? Ethical considerations and end-stage lung disease

The treatment of patients with end-stage lung disease is very expensive. In an era of cost containment, the physician could be forced to restrict his therapy in order to spend less. But does the physician really have the right to restrict a reasonable therapy for economic reasons? It is argued that the mission of medicine is to help people in need and that any confidence is shaken if the physician is forced to be both physician and gatekeeper at the same time. It is argued that medicine as a central form of care will only be able to survive if it has the chance to remain a free profession, a profession which has the liberty to help each individual patient even if this help is expensive. However, it remains a duty of the physician to accept limits and to learn that for a good death it is necessary to be honest and to talk early enough about the possibilities of palliative care.     

The Fate of Prothrombin and Factors VIII, IX and X Transfused to Patients Deficient in these Factors

T he treatment of patients with coagulation defects consists of an attempt temporarily to replace in their blood the factor they lack. This is achieved by giving whole plasma or concentrates of the appropriate factor prepared from human or animal blood. There is now no reasonable doubt that this treatment is effective. With increasing precision of the methods used to assay the different factors it is becoming possible to relate the blood level achieved in the patient to the dose of material administered and to study the rate of disappearance of the factor from the patient's circulation. Accumulation of this information for all treated patients should improve treatment. If bleeding is related to the concentration of a particular factor in the patient's blood, it is clearly important to be able to predict what concentration is likely to be reached after a given dose and to predict how long it is likely to be maintained. If the response of patients to therapeutic material prepared by different methods is not the same, this again is important because allowances must be made for the variations in calculating the effective dose.
The purpose of the present communication is to present the results of studies recently made at Oxford during the routine treatment of patients admitted to the Oxford hospitals. Assays were made of the blood levels of the relevant factor before and after the administration of a variety of therapeutic materials. The blood levels achieved were related to the calculated amount of the factor given and the rate of its disappearance from the blood was recorded. In this study the case records are not given in detail, nor is there any discussion of the therapeutic effectiveness of treatment in any particular case.     

The injury-spasm (ischemia-induced hemostatic vasoconstrictive) and vascular autoregulatory hypothesis of ischemic disease: Resistance vessel-spasm hypothesis of ischemic disease

The injury-spasm concept assumes that severe myocardial ischemia secondary to stenotic coronary artery disease causes spasm of resistance vessels through ischemic tissue injury. In this communication the concept is developed further and is now extended to include other diseases. It is suggested that relative arterial insufficiency, as traditionally understood, is an invalid concept and that disorders usually attributed to it, including congestive heart failure and peripheral vascular disease, should be attributed to injury-spasm. Because a basic reaction to injury is to prevent bleeding, injury-spasm is identified as an exaggerated form of hemostatic vasoconstriction, and spasm is related to distorted vascular autoregulatory activities of resistance vessels. It is asserted that blood platelets probably are not involved in the initiation of ischemic attacks, and instead of a platelet thromboxane/vessel prostacyclin vasomotor balance of epicardial coronary arteries, the vasoconstrictive/vasodilative balance is centered in resistance vessels and is based on autoregulatory processes such as the hemostatic injury-spasm reaction and reactive hyperemia.     

The harmful, nontherapeutic use of animals in research is morally wrong

It is argued that using animals in research is morally wrong when the research is nontherapeutic and harmful to the animals. This article discusses methods of moral reasoning and discusses how arguments on this and other bioethical issues might be defended and critiqued. A basic method of moral argument analysis is presented and used to show that common objections to the view that "animal research is morally wrong" fail: ie, common arguments for the view that "animal research is morally permissible" are demonstrably unsound or in need of defense. It is argued that the best explanations why harmful, nontherapeutic research on human beings is wrong, ie, what it is about humans that makes such experimentation wrong, apply to many animals as well. Thus, harmful and nontherapeutic animal experimentation is wrong for reasons similar to the reasons that harmful and nontherapeutic human experimentation is wrong.     

How can we prevent multisystem complications of cystic fibrosis?

Cystic fibrosis (CF) is a multisystem disease. Some of this is accounted for by CF transmembrane regulator (CFTR) dysfunction in individual organs but in some cases this is compounded by the effects of systemic inflammation. The inflammation is in response to the chronic infection in the airways and is particularly important as a contributor to CF-related bone disease, CF-related diabetes mellitus, CF-related arthropathy, and vasculitis. Preventing these multisystem complications is difficult. Aggressive specific therapies to treat complications is critically important to maintain nutrition, stop the damaging effects of diabetes, and improve bone mineral density. Aggressive treatment of lung disease to reduce systemic inflammation is likely to be of benefit in preventing the development of CF-related bone disease and may be beneficial in at least delaying the onset of CF-related diabetes. Aggressive treatment of pulmonary infection and inflammation in conjunction with holistic management plans to treat specific organ diseases is an important strategy in improving morbidity and reducing mortality in people with CF.     

Intraventricular neurocysticercosis: Presentation,diagnosis and management

Neurocysticercosis is thought to be the most common helminthic infection of the central nervous system and its epidemiology is changing due to increasing travel and migration.Evidence to guide management of the intraventricular form is limited.We aimed to review the clinical presentation,diagnosis and treatment of intraventricular neurocysticercosis with reference to two recent cases seen at our institution.The intraventricular variant of neurocysticercosis is less common than parenchymal disease and usually presents with acutely raised intracranial pressure and untreated it progresses rapidly with high mortality.The diagnosis is based on imaging and serological tests but more invasive testing including histopathological examination of surgically acquired tissue specimens is sometimes required.Treatment is mainly surgical,using a neuroendoscopic approach if possible.Patients should also receive antihelmintic treatment with concomitant corticosteroids to reduce the incidence of shunt failure if a ventricular shunt is inserted and to treat viable lesions elsewhere.     

骨髓基质干细胞自体移植治疗心肌梗死的研究进展

骨髓基质干细胞(MSC)具有良好的分化潜能,能分化为心肌细胞和血管内皮细胞,从而再生心肌和血管,重塑心肌结构,改善心肌收缩功能和室壁顺应性,促进血管再生,建立有效冠脉侧枝循环,提高心脏整体功能,既改善了血供又解决心肌细胞数量减少这一心力衰竭的根本原因;而自体移植不受来源限制,取材方便、创伤小,更新率低而代谢活力高,由其分化来的心肌细胞能与周围受体肌肉细胞进行有效的电机械偶合,容易通过转基因技术获得目标基因并在体内外长期表达,也不存在免疫排斥和基因突变等安全性问题,因此作为心肌梗死(MI)疾病治疗的新途径有着广阔的前景.现就近年来国内外MSC自体移植在治疗MI方面的研究进展作一综述.     

Superoxide dismutase: an evolutionary puzzle.

We have obtained the complete amino acid sequence of copper/zinc-containing superoxide dismutase (SOD, superoxide:superoxide oxidoreductase, EC 1.15.1.1) from Drosophila melanogaster. The sequence of this enzyme is also known for man, horse, cow, and the yeast Saccharomyces cerevisiae. The rate of evolution of this enzyme is far from constant. The number of amino acid substitutions per 100 residues per 100 million years is 30.9 when the three mammals are compared to each other, 10.6 when Drosophila is compared to the three mammals, and 5.8 when the yeast is compared to the four animals. The first value represents one of the fastest evolutionary rates for any protein, the second is similar to the globin rate, and the third is similar to some cytochromes and other slowly evolving proteins. Hence, SOD is not an acceptable evolutionary clock. Another peculiarity of this enzyme is that a two-amino-acid deletion must have occurred independently in the lineages going to the cow and to Drosophila. We conclude that using the primary structure of a single gene or protein to time evolutionary events or to reconstruct phylogenetic relationships is potentially fraught with error.     

The effects of the pericardium on function of normal and enlarged hearts

In summary, the pericardium is a membranous structure that surrounds the heart. Its physical properties are such that it is distensible when the total intrapericardial volume is small and inextensible when total intrapericardial volume is large. The pericardium serves to limit acute cardiac distention and to modulate the phenomenon of ventricular interdependence. It is a dynamic structure that, when subjected to chronic stretching--either due to the gradual accumulation of intrapericardial fluid or to cardiac enlargement--will grow to accommodate its contents, such that the working range of pressures between it and the surface of the heart is low. The precise level of cardiac distention that is necessary to engage the pericardium is unknown, but studies in normal and dilated hearts suggest that, at the upper end of the normal volume range of the heart, the intrapericardial volume is just sufficient to reach the noncompliant portion of the tissue's length-tension relation. Further studies are needed to determine whether this behavior represents a hemodynamic protective mechanism in normal animals.     

Airway smooth muscle in asthma: Phenotype plasticity and function

Clinical asthma is characterized by reversible airway obstruction which is commonly due to an exaggerated airway narrowing referred to as airway hyperresponsiveness (AHR). Although debate exists on the complex etiology of AHR, it is clear that airway smooth muscle (ASM) mediated airway narrowing is a major contributor to airway dysfunction. More importantly, it is now appreciated that smooth muscle is far from being a simple cell with only contractile ability properties. Rather, it is more versatile with the capacity to exhibit numerous cellular functions as it adapts to the microenvironment to which it is exposed. The emerging ability of individual smooth muscle cells to undergo changes in their phenotype (phenotype plasticity) and function (functional plasticity) in response to physiological and pathological cues is an important and active area of research. This article provides a brief review of the current knowledge and emerging concepts in the field of ASM phenotype and function both under healthy and asthmatic conditions.