Clinico-endoscopic data and the status of local immunity in intestinal lesions in patients with periodic disease]

Clinicoendoscopic and immunological evaluation of periodic disease patients shows that the disease-related inflammation of the colon is pathogenetically coupled with secretory IgA hypoproduction and abnormal intestinal eubiotic microflora. These facts should be allowed for when making differential diagnosis between periodic disease and gastrointestinal inflammations.     

Clinico-endoscopic diagnosis of cancer of the large intestine

Appearance of the clinical signs of large-intestinal cancer usually demonstrates advanced stages of the process. Endoscopic polypectomy, along with screening and active follow-up of patients, can be one of the measures for identification and prevention of tumours in early terms.     

Clinico-endoscopic and morphologic characteristics of patients with Campylobacter infection

Bacteriological examination of feces of 120 patients with signs of acute gastroenterocolitis revealed C. jejuni infection in 19 (7 per cent) of them. There was a certain difference between the clinical course of C. jejuni infection and acute dysentery. The endoscopic examination of the large intestine in jejuni infection demonstrated acute hemorrhagic or catarrhal colitis and phenomena of acute exudative inflammation were found during histomorphological study. C. jejuni infection can be diagnosed on the basis of the clinico-epidemiological findings and the results of bacteriological examination of the patients' feces.     

Parasystole and its variants.

Various mechanisms that cause deviations from the classical manifestations of a parasystolic rhythm are reviewed and illustrated by selected clinical electrocardiograms. They consist of: (1) Transient or continued fixed coupling of the ectopic beats, due to (a) synchronization of basic and parasystolic rhythms; (b) reversed coupling of the basic to the ectopic rhythm (unidirectional protection); (c) the operation of supernormal phase of excitability; and (d) intermittent parasystole, due to gap in the protection of the parasystolic center. (2) Irregularities in response to a regular parasystolic discharge may be caused by a second degree exit block, usually of Mobitz type II, rarely of type I. An electrophysiologic basis for the emergence and maintenance of parasystolic rhythms appears to be abnormal states of spontaneous diastolic (phase 4) depolarization in otherwise latent subsidiary cardiac pacemakers.     

Clinical variants and treatment of urological sepsis

The paper describes current clinical features of urological sepsis, factors provoking sepsis in urological patients, leading laboratory and clinical characteristics of the disease, principles of treatment and its results.     

Gout and its differential diagnosis

Arthritis urica is one of the most frequent forms of arthritis in Switzerland. On one hand it can mimic septic arthritis, on the other hand it may progress into chronic polyarticular disease. Age, sex and initial clinical presentation lead to the suspicion of crystal arthropathy. The diagnosis, however, has to be proven by microscopic analysis of synovial fluid. Functional ultrasound may be extremely helpful in collecting minute amounts of liquid in small joints. This approach enables definite diagnosis and at the same time crystalline glucocorticoids together with local anesthetics can be injected intra-articularly in order to interrupt the inflammatory process and to kill pain. Other conventional treatment modalities include non-steroidal anti-inflammatory drugs (including Cox-2 inhibitors) which should be started immediately and at maximal doses as well as glucocorticoids at moderate doses for a few days. Serum uric acid levels should be normalized in order to prevent recurrence of arthritis.     

Relationship between microsatellite status and immune microenvironment of colorectal cancer and its application to diagnosis and treatment

Due to advances in understanding the immune microenvironment of colorectal cancer (CRC), microsatellite classification (dMMR/MSI‐H and pMMR/MSS) has become a key biomarker for the diagnosis and treatment of CRC patients and therefore has important clinical value. Microsatellite status is associated with a variety of clinicopathological features and affects drug resistance and the prognosis of patients. CRC patients with different microsatellite statuses have different compositions and distributions of immune cells and cytokines within their tumor microenvironments (TMEs). Therefore, there is great interest in reversing or reshaping CRC TMEs to transform immune tolerant "cold" tumors into immune sensitive "hot" tumors. This requires a thorough understanding of differences in the immune microenvironments of MSI‐H and MSS type tumors. This review focuses on the relationship between CRC microsatellite status and the immune microenvironment. It focuses on how this relationship has value for clinical application in diagnosis and treatment, as well as exploring the limitations of its current application.     

透析患者社会支持状况调查分析及护理对策

目的　了解接受透析的慢性肾功能衰竭患者的社会支持情况。方法　对 91例接受透析治疗 3个月以上的慢性肾功能衰竭患者 (血透和腹透 )应用肖水源的《社会支持评定量表》 ,调查分析透析患者的社会支持状况。结果　透析患者获得的社会支持总分为 (34.6 8± 5 .32 ) ,与对照组总分 (38.5 9± 5 .76 )比较 ,差异有统计学意义 (P <0 .0 1) ,有获得低水平社会支持的危险。老年、丧偶、离异、家庭年收入低和完全自费的透析患者获得的社会支持更低 ,是社会支持较低的弱势群体。结论　护士通过整体护理手段 ,不仅应全面评估患者状况 ,更应对社会支持状况作出评估 ,早期干预 ,加强社会支持 ,从而改善慢性肾功能衰竭患者的生活质量     

Delusions of parasitosis: differential diagnosis and treatment

Delusions of parasitosis, or a patient's persistent belief that he has cutaneous invasion by parasites despite medical evidence to the contrary, is an uncommon syndrome associated with a wide variety of medical and psychiatric disorders. Its prognosis has been improved considerably by the introduction of pimozide, a potent neuroleptic agent.