脉络膜前动脉梗死的研究进展

脉络膜前动脉梗死[anterior choroidal artery (AChA) infarction]是脑梗死的特定类型,又称为Abbie综合征,其病因及发病机制尚不完全明了,临床表现比较复杂,诊断和治疗难度相对较大。本研究介绍脉络膜前动脉(AChA)的解剖结构特征和血液供应分布,分析国内外对AChA梗死病因、发病机制、临床表现及治疗的研究进展。目前仍需要对AChA梗死的危险因素、发病机制及治疗等进行深入研究。     

应当关注慢性阻塞性肺疾病和阻塞性睡眠呼吸暂停的共存问题

目前对于COPD和阻塞性睡眠呼吸暂停(OSA)的病因、发病机制、临床表现、合并症、鉴别诊断、治疗和预后均已有较深入的了解,但对于2种疾病共存即重叠综合征的发病机制、临床表现、危害和治疗则知之不多或不够重视.     

多组学研究在库欣综合征临床诊疗中的应用前景

库欣综合征是由肾上腺皮质长期过量分泌皮质醇而导致的临床症候群, 由于其不同的病因及临床特征, 复杂性较高、异质性较强、并发症及远期疾病风险较高, 对于临床诊疗造成较大的挑战。近年来, 随着高通量分子生物技术的快速发展, 不同组学技术在库欣综合征的发病机制、精准分型、病因诊断以及潜在治疗手段研发中逐渐广泛应用。本文旨在总结并归纳库欣综合征相关的组学研究现状、研究的临床意义以及未来的应用前景。     

短暂的左室气球样变:一种独特的心脏综合征

短暂的左室气球样变,又称"tako-tsubo"样心肌病,是一组独特的心脏综合征,目前对其命名、病因、诊断标准等仍有争议.本文对其临床特点及意义、诊断标准、病因及发病机制、病理学改变等几方面作一综述.     

短暂的左室气球样变：一种独特的心脏综合征

短暂的左室气球样变，又称“tako—tsubo”样心肌病，是一组独特的心脏综合征，目前对其命名、病因、诊断标准等仍有争议。本文对其临床特点及意义、诊断标准、病因及发病机制、病理学改变等几方面作一综述。     

布-加综合征模型的构建及进展

布-加综合征是由肝静脉或其开口以上的下腔静脉阻塞引起的门静脉高压伴或不伴有下腔静脉高压的临床综合征,中国人群主要以下腔静脉隔膜形成和(或)阶段性合并肝静脉梗阻为特征。目前人们对布-加综合征的病因和发病机制所知甚少,所做研究多为诊治策略方面的临床研究,针对其发病机制的实验探索相对稀缺,而稳定模型往往是疾病机制研究的必要条件。就目前布-加综合征模型的构建方法、各种模型的特点和研究进展作一综述和分析,以便为该病病因和发病机制的探索提供可靠的实验基础。     

发作性睡病及其研究进展

发作性睡病是一种临床少见的睡眠障碍综合征,由Gelineau和Westphal于1880年提出并描述.主要表现为白天过度嗜睡、猝倒发作、睡眠瘫痪和睡眠幻觉四联症.目前病因及机制尚未明确,治疗以对症治疗为主.近十年来发作性睡病的研究和认识逐渐深入,但大多数临床医师对本病认识仍不足,误诊及漏诊常见,易与睡眠呼吸暂停综合征、特发性嗜睡症、癫痫等疾病相混淆.因此,正确认识、诊断该病具有重要意义.     

肝性脊髓病的研究及进展

肝性脊髓病 (hepaticmyelopathy .HM )是多种肝病引起的颈髓以下脊髓侧索脱髓鞘病变 ,呈现肢体缓慢进行性对称性痉挛性瘫痪。本病最早由Leih和Cand在 194 9年报告[1] ,196 0年Zieve[2 ] 描述 2例病理改变。我院内科神经病小组于 1976年在国内首次报告本病[3] 。随着肝病病因研究的进展和诊疗技术的提高 ,有必要更深入的了解HM ,以利于及时的诊断治疗和判断预后。1　病因和发病机制HM多见于肝硬化 ,偶见于急慢性肝炎、慢性间质性肝炎、重症肝炎、先天性肝纤维化、酒精性脂肪肝及肝豆状核变性等。本病病因和发病机制尚未清楚 ,因绝大多数H…     

咽喉反流病与胃食管反流病关系的研究进展

咽喉反流病与胃食管反流病是耳鼻喉及消化系统的常见疾病,因为患病率的不断增高,二者的诊断与治疗不断受到重视。但因其二者的发病机制仍不完全明确,目前的诊疗仍存在争议。本文结合国内外有关咽喉反流病与胃食管反流病的文献,通过二者发病机制、诊疗现状的特点,阐述其关系,以为后续的研究和临床实践提供参考。     

阿尔茨海默病的人脑蛋白质组学研究进展

阿尔茨海默病(AD)是以记忆力减退、认知功能障碍为特征的中枢神经系统变性疾病,但其发病机制仍不清楚.将蛋白质组学技术应用于大脑研究其关键问题在于查找病因及发病机制,从而实现早期诊断、有效治疗及筛选大量治疗药物[1].目前本领域的研究主要归纳为如下几个方面.     

Control of intraabdominal hemorrhage and shock: a comparison of fluid resuscitation, MAST, and balloon occlusion

Our study examined the efficacy of four treatment modalities in controlling hemorrhage and achieving hemodynamic stabilization in hemorrhagic shock: intravenous fluid replacement (IV); military antishock trousers used concomitantly with fluids (MAST); balloon occlusion at the level of the diaphragm with concomitant fluid replacement (balloon); and a combination of MAST inflation, balloon occlusion, and fluid resuscitation (MAST and balloon). Twenty-eight mongrel dogs were anesthetized, and the spleen was exposed and completely crushed. The abdomen was closed, and treatment was initiated and continued for four hours or until the dog died. For all conditions the hematocrit dropped during the course of the experiment; balloon occlusion was effective at slowing this drop (P less than .0001), but MAST had no statistically significant effect. Animals with balloons bled more slowly into the abdominal cavity than did animals in the other two groups (P less than .0001). MAST also were effective at slowing the bleeding (P less than .05). Of the balloon and the MAST and balloon dogs, all except one survived the entire four hours; this difference between balloon and nonballoon dogs is significant (P = .002). MAST did not have a statistically significant effect on survival. Perfusion pressure (PP) declined during the course of the experiment, and the balloon was effective at slowing this decline (P less than .0001); none of the other comparisons was statistically significant.     

A Call to Action to Enhance Filovirus Disease Outbreak Preparedness and Response

The frequency and magnitude of recognized and declared filovirus-disease outbreaks have increased in recent years, while pathogenic filoviruses are potentially ubiquitous throughout sub-Saharan Africa. Meanwhile, the efficiency and effectiveness of filovirus-disease outbreak preparedness and response efforts are currently limited by inherent challenges and persistent shortcomings. This paper delineates some of these challenges and shortcomings and provides a proposal for enhancing future filovirus-disease outbreak preparedness and response. The proposal serves as a call for prompt action by the organizations that comprise filovirus-disease outbreak response teams, namely, Ministries of Health of outbreak-prone countries, the World Health Organization, Médecins Sans Frontières, the Centers for Disease Control and Prevention—Atlanta, and others.     

Interplay between interferon-mediated innate immunity and porcine reproductive and respiratory syndrome virus

Innate immunity is the first line of defense against viral infection, and in turn, viruses have evolved to evade host immune surveillance. As a result, viruses may persist in host and develop chronic infections. Type I interferons (IFN-α/β) are among the most potent antiviral cytokines triggered by viral infections. Porcine reproductive and respiratory syndrome (PRRS) is a disease of pigs that is characterized by negligible induction of type I IFNs and viral persistence for an extended period. For IFN production, RIG-I/MDA5 and JAK-STAT pathways are two major signaling pathways, and recent studies indicate that PRRS virus is armed to modulate type I IFN responses during infection. This review describes the viral strategies for modulation of type I IFN responses. At least three non-structural proteins (Nsp1, Nsp2, and Nsp11) and a structural protein (N nucleocapsid protein) have been identified and characterized to play roles in the IFN suppression and NF-κB pathways. Nsp's are early proteins while N is a late protein, suggesting that additional signaling pathways may be involved in addition to the IFN pathway. The understanding of molecular bases for virus-mediated modulation of host innate immune signaling will help us design new generation vaccines and control PRRS.     

Disease Pandemics and Major Epidemics Arising From New Encounters between Indigenous Viruses and Introduced Crops

Virus disease pandemics and epidemics that occur in the world’s staple food crops pose a major threat to global food security, especially in developing countries with tropical or subtropical climates. Moreover, this threat is escalating rapidly due to increasing difficulties in controlling virus diseases as climate change accelerates and the need to feed the burgeoning global population escalates. One of the main causes of these pandemics and epidemics is the introduction to a new continent of food crops domesticated elsewhere, and their subsequent invasion by damaging virus diseases they never encountered before. This review focusses on providing historical and up-to-date information about pandemics and major epidemics initiated by spillover of indigenous viruses from infected alternative hosts into introduced crops. This spillover requires new encounters at the managed and natural vegetation interface. The principal virus disease pandemic examples described are two (cassava mosaic, cassava brown streak) that threaten food security in sub-Saharan Africa (SSA), and one (tomato yellow leaf curl) doing so globally. A further example describes a virus disease pandemic threatening a major plantation crop producing a vital food export for West Africa (cacao swollen shoot). Also described are two examples of major virus disease epidemics that threaten SSA’s food security (rice yellow mottle, groundnut rosette). In addition, brief accounts are provided of two major maize virus disease epidemics (maize streak in SSA, maize rough dwarf in Mediterranean and Middle Eastern regions), a major rice disease epidemic (rice hoja blanca in the Americas), and damaging tomato tospovirus and begomovirus disease epidemics of tomato that impair food security in different world regions. For each pandemic or major epidemic, the factors involved in driving its initial emergence, and its subsequent increase in importance and geographical distribution, are explained. Finally, clarification is provided over what needs to be done globally to achieve effective management of severe virus disease pandemics and epidemics initiated by spillover events.     

Barrett's Esophagus: Where Do We Stand?

Barrett''s esophagus (BE) is a precursor for esophageal adenocarcinoma, which has an increased incidence rate over the last few decades. Its importance stems from the poor five-year survival of esophageal adenocarcinoma and current data that suggest a survival benefit when surveillance programs are implemented. In this review, we will cover the pathophysiology and natural history of BE and the different endoscopic findings. The prevalence of BE in different geographic areas and the incidence of high-grade dysplasia and adenocarcinoma in this patient population is reviewed. Recent recommendation for screening and surveillance of BE has been covered in this review as well as the efficacy of nonconventional imaging modalities and endoscopic ablation therapies.     

The Technology Transfer from Europe to China in the 17th–18th Centuries: Non-Invasive On-Site XRF and Raman Analyses of Chinese Qing Dynasty Enameled Masterpieces Made Using European Ingredients/Recipes

Two masterpieces of the Qing Dynasty (1644–1912 CE), one in gilded brass (incense burner) decorated with cloisonné enamels stylistically attributed to the end of the Kangxi Emperor’s reign, the other in gold (ewer offered by Napoleon III to the Empress as a birthday present), decorated with both cloisonné and painted enamels bearing the mark of the Qianlong Emperor, were non-invasively studied by optical microscopy, Raman microspectroscopy and X-ray microfluorescence spectroscopy (point measurements and mapping) implemented on-site with mobile instruments. The elemental compositions of the metal substrates and enamels are compared. XRF point measurements and mappings support the identification of the coloring phases and elements obtained by Raman microspectroscopy. Attention was paid to the white (opacifier), blue, yellow, green, and red areas. The demonstration of arsenic-based phases (e.g., lead arsenate apatite) in the blue areas of the ewer, free of manganese, proves the use of cobalt imported from Europe. The high level of potassium confirms the use of smalt as the cobalt source. On the other hand, the significant manganese level indicates the use of Asian cobalt ores for the enamels of the incense burner. The very limited use of the lead pyrochlore pigment (European Naples yellow recipes) in the yellow and soft green cloisonné enamels of the Kangxi incense burner, as well as the use of traditional Chinese recipes for other colors (white, turquoise, dark green, red), reinforces the pioneering character of this object in technical terms at the 17th–18th century turn. The low level of lead in the cloisonné enamels of the incense burner may also be related to the use of European recipes. On the contrary, the Qianlong ewer displays all the enameling techniques imported from Europe to obtain a painted decoration of exceptional quality with the use of complex lead pyrochlore pigments, with or without addition of zinc, as well as cassiterite opacifier.