代谢性疾病与卒中Fabry病

~~思考题1Fabry病患者会出现下列哪种临床表现?A肢端感觉异常B血管角质瘤C肾功能衰竭D卒中E以上都是2一例Fabry病患者,通过详细的体格检查可能发现下列哪种体征?A晶状体混浊B偏瘫C心脏扩大D点状皮肤损害E以上都是3Fabry病患者的卒中通常会发生在大脑中动脉供血区。A正确B错误4F     

Peripheral Artery Disease and Aortic Disease

We reviewed published MESA (Multi-Ethnic Study of Atherosclerosis) study articles concerning peripheral arterial disease, subclavian stenosis (SS), abdominal aortic calcium (AAC), and thoracic artery calcium (TAC). Important findings include, compared to non-Hispanic whites, lower ankle-brachial index (ABI) and more SS in African Americans, and higher ABI and less SS in Hispanic and Chinese Americans. Abnormal ABI and brachial pressure differences were associated with other subclinical cardiovascular disease (CVD) measures. Both very high and low ABI independently predicted increased CVD events. Looking at aortic measures, TAC and AAC were significantly associated with other subclinical CVD measures. Comparisons of AAC with coronary artery calcium (CAC) showed that both were less common in ethnic minority groups. However, although CAC was much more common in men than in women in multivariable analysis, this was not true of AAC. Also, when AAC and CAC were adjusted for each other in multivariable analysis, there was a stronger association for AAC than for CAC with CVD and total mortality.     

微血管病变与缺血性心脏病

冠状动脉微血管在心肌的血供中起着重要作用,冠状动脉微循环对冠心病的发生、发展、疗效及预后具有重要影响而备受人们重视。目前冠状动脉微血管病变主要分为X综合征和冠脉内慢血流现象,二者都与缺血性心脏病存在着密切的关系,但发病机制有所不同。X综合征主要是冠状动脉微血管痉挛所致,而冠脉内慢血流现象传统上被认为与微血管功能失调有关。此外慢血流现象可能是缺血性心脏病的一种新的发病机制,它可能代表了动脉粥样硬化和内皮功能失调的早期阶段。并且二者在治疗上有所不同。     

酒精性肝病及其相关疾病

长期大量饮酒损伤肝脏 ,形成酒精性脂肪肝 ,酒精性肝炎及酒精性肝硬化。欧美国家肝硬化患者 ,1/ 2～1/ 3由长期酗酒所致。我国酒精消耗量近年明显增加 ,据估计酗酒人群中 10 %～ 2 0 %有着不同程度的酒精性肝病。一、酒精在肝内的代谢饮入的酒精一部分经胃的酒精脱氢酶 (ＡＤＨ)代谢 ,吸收后 90 %以上经肝脏氧化、代谢 ,最后生成ＣＯ2和水 ;少部分由肺、肾和汗排出。酒精在肝内代谢 ,主要为ＡＤＨ氧化途径和微粒体乙醇氧化系统 (ＭＥＯＳ)。虽然还有过氧化物酶和过氧化氢酶酒精代谢 ,但其作用微不足道。 (图Ⅰ )ＡＤＨ氧化途径 :酒精在肝细…     

Metabolic Bone Disease in Inflammatory Bowel Disease

Opinion statement  

Association of Cardiovascular Disease With Respiratory Disease

Background

The relationship between respiratory diseases and individual cardiovascular diseases, and the impact of cardiovascular diseases on mortality in patients with respiratory disease, are unclear.

Radiation-related Coronary Artery Disease in Hodgkin's Disease

Summary: Radiation-related coronary artery disease in Hodgkin's disease. A. S. Y. Leong, I. J. Forbes and T. Ruzic, Aust. N.Z. J. Med., 1979, 9, pp. 423–425.
Coronary artery disease is a rare and only recently recognised complication of mediastinal irradiation. A 34-year-old man died suddenly eight years after mediastinal irradiation for Hodgkin's disease. Autopsy disclosed severe narrowing of all major extramural coronary arteries by atherosclerotic plaques whereas all other systemic and visceral arteries were virtually free of atheroma. Autopsy findings in the five reported cases of radiation-related coronary artery disease are reviewed.     

Antiglomerular Basement Membrane Disease Associated With Castleman Disease

We described a 33-year-old man with gross hematuria and acute renal failure, who had suffered from fever for 6 months, multiple cervical lymph node swelling, splenomegaly, left-sided pleural effusion. He also suffered from anemia, thrombocytopenia, hypergammaglobulinemia, and his serum interleukin-6 levels were markedly elevated. Antiglomerular basement membrane antibodies were positive in the patient’s serum. Lymph node biopsy results were compatible with Castleman disease of “plasma cell” variant. Renal biopsy revealed cellular crescents in most of the glomeruli. Immunofluorescence studies showed strong deposition of IgG in a linear pattern along the glomerular basement membrane. Pathologic features were compatible with crescentic glomerulonephritis because of antiglomerular basement membrane disease. With intensive plasmapheresis and monthly chemotherapy (cyclophosphamide, oncovin, prednisone regimen), the patient experienced clinical and biochemical remission. Although autoimmune phenomenon had been described frequently in Castleman disease, to the best of our knowledge, this was the first report that the patient with rapid progressive glomerulonephritis mediated by antiglomerular basement membrane antibodies, which might be associated with Castleman disease.     

Non-alcoholic Fatty Liver Disease and Cardiovascular Disease Risk

Non-alcoholic fatty liver disease (NAFLD) is an increasingly recognized cause of liver disease in the United States and worldwide. Increasing recognition of the importance of NAFLD and its strong relationship with the metabolic syndrome has stimulated an interest in the possible role of NAFLD in the development and progression of cardiovascular disease (CVD). Recent prospective studies demonstrated that NAFLD, especially in its necroinflammatory form (NASH), is linked to an increased risk of CVD, independently of obesity and other shared cardiometabolic risk factors. This suggests that NAFLD/NASH is not merely a marker of CVD, but may also be actively involved in its pathogenesis, possibly through the systemic release of proinflammatory/proatherogenic factors from the inflamed/steatotic liver as well as the contribution of NAFLD per se to whole-body insulin resistance and atherogenic dyslipidemia. Health care providers managing NAFLD patients should recognize this increased CVD risk and undertake early, aggressive risk factor modification.     

幽门螺杆菌与心脑血管疾病

幽门螺杆菌是重要的胃肠道细菌。近年来发现,其与包括心脑血管疾病在内诸多胃肠外疾病的发生发展有关,成为新的研究热点。本文就幽门螺杆菌与心血管疾病的近期研究作一综述。     

他汀类药物,从心血管疾病到肾脏病

随着他汀类药物在临床上的广泛应用,其降脂和各种降脂外作用能在很大程度上减少心血管事件发生的风险;同时,人们也对他汀类药物在慢性肾脏疾病中的肾保护作用产生了浓厚的兴趣,开展了一系列的试验研究来揭示他汀类药物的多效性,现就此做一综述。     

Infectious Disease

2012035 The differences of rpoB mutations in rifampicin/rifabutin cross-resistant clinical isolates of Mycobacterium tuberculosis.HU Zuqiong(胡族琼),et al.Dept Clin Lab,Guangzhou Chest Hosp,