Segmental chronic cholecystitis: sonographic findings and clinical manifestations

Background: In chronic cholecystitis, the gallbladder (GB) wall is usually evenly involved, whereas marked segmental thickening of the GB wall (segmental cholecystitis) seldom is reported. We wanted to define its clinical manifestations and sonographic (US) findings. Methods: We reviewed the clinical and US data of 13 cases and compared these results with those of 30 patients with chronic cholecystitis with evenly thickened GB walls (usual-cholecystitis group). Results: (a) All cases of segmental cholecystitis showed the portion distal to the kinking to be markedly thickened. (b) The thickened portion corresponded to the fundus in three cases, the body and fundus in seven cases, and the fundus, body, and infundibulum in three cases; and the thickened distal portion contained many stones in 11 cases. (c) There was no difference in the maximal diameters of the GB walls between the segmental-cholecystitis group and the usual-cholecystitis group. However, there was a significant difference in the minimal diameters of the GB walls between groups. Conclusion: Knowledge of the US findings and clinical presentations of segmental cholecystitis can help in the development of appropriate diagnostic and therapeutic strategies. Received: 22 February 2001/Accepted: 21 March 2001     

Diagnostics and therapeutic approach in clinical remission of chronic bronchitis

Clinical examination and laboratory tests performed on 708 patients with chronic obstructive and non-obstructive bronchitis (COB and CNB), demonstrated heterogeneous character of the group of these patients in clinical remission. This suggests that it is appropriate to distinguish between the stages of complete and partial remission, implying different tasks concerning treatment and rehabilitation. Remission of CNB is characterized by minimal deviation of clinical and laboratory parameters; functional balance between the lipid peroxidation-antioxidative activity (LP-AA) system and immunity is preserved. At the stage of rehabilitation of these patients the major attention is paid to the general sanitary measures (physiotherapy exercises, climate therapy). The stage of partial remission in COB and CNB is characterized by residual activity of the inflammatory process, a disbalance between the LP-AA system and immunity, most prominent in partial remission of COB. Rehabilitation of these patients, in addition to physiotherapy exercises and tempering of the organism, should include special activity, directed towards the normalization of LP and immunity parameters.     

过敏原检测对小儿毛细支气管炎的临床意义探讨

目的：探讨研究过敏原检测,对于小儿毛细支气管炎的临床意义。方法：选取我院儿科确诊的21例毛细支气管炎患儿作为观察组,同期住院的其他患儿21例作为对照组,均进行血清特异性IgE检测。通过两组患儿的血清特异性IgE水平以及随访3个月后的喘息发生率比较两组检测结果的意义。结果：观察组患儿血清特异性IgE水平显著高于对照组（P＆lt;0.05）,随访3个月后观察组患儿喘息发生率高于对照组,差异有显著性（P＆lt;0.05）。结论：对毛细支气管炎患儿进行过敏原检测,可有效预测病情的严重程度和转归,有利于避开相关的触发因素,预防反复喘息发作甚至哮喘发生。     

Moxifloxacin in acute exacerbations of chronic bronchitis: clinical evaluation and assessment by patients

The clinical success of a 5-day course of oral moxifloxacin (administered once daily at a dose of 400 mg) was evaluated in 328 patients with acute exacerbations of chronic bronchitis (Anthonisen type 1) in a non-comparative study conducted by chest physicians in private practice. Results were assessed on the basis of clinical parameters and, for the first time in a trial involving oral moxifloxacin, by the surrogate marker of patient satisfaction. Improvement in (and severity of) cough, dyspnoea, chest pain and sputum were scored daily by patients. Cough, chest pain and purulent sputum production improved rapidly within the first 5 days of treatment. At least 90% of patients were satisfied with the antibiotic. The clinical success rate (cure and improvement) for all patients involved (intent-to-treat analysis) was 90.5%. The most commonly experienced adverse events were gastrointestinal related, with diarrhoea the most frequent of these (2.7% of all patients).     

Acute and chronic bronchitis

Formation of a fistula between the gallbladder and bowel may allow a gallstone to enter the intestinal tract. In the two cases described here, the colon was involved. The authors describe diagnosis and management of these cases and make treatment recommendations based on their experience.     

CysC与NT-proBNP水平在慢性心力衰竭中的变化及意义

目的观察慢性心力衰竭（chronic heart failure,CHF）患者血清胱抑素C（Cystatin C,CysC）以及N端脑钠肽前体（N-Terminal pro-brain natriuretic peptide,NT-proBNP）水平的变化,并探讨其临床意义。方法将57例CHF患者按照美国纽约心脏病学会心功能分级标准（New York Heart Association,NYHA）进行分级,分为Ⅱ、Ⅲ、Ⅳ级。选取健康对照组51例。分别测定血清CysC、血浆NT-proBNP水平以及左室射血分数（left ventricularejection fraction,LVEF）,并进行相关性分析。结果 CHF组血清CysC以及血浆NT-proBNP水平高于健康对照组（P〈0.01）,并且CHF组内随着CHF程度的加重,CysC以及NT-proBNP的水平也升高。相关性分析发现,CHF组血清CysC与LVEF呈中等负相关（r=-0.793,P〈0.01）,CHF组血浆NT-proBNP与LVEF呈中等负相关（r=-0.618,P〈0.01）,CHF组血清CysC与血浆NT-proBNP呈中等正相关（r=0.742,P〈0.01）。结论血清CysC以及血浆NT-proBNP与心力衰竭密切相关,可以反映CHF的心功能,有利于临床上对心力衰竭的早期诊断和治疗。