2010美国心脏病学会基金会/美国心脏学会关于氯吡格雷的应用警告概述

2010年8月,美国心脏病学会基金会（ACCF）、美国心脏学会（AHA）共同发布了美国食品药品管理局（FDA）关于氯吡格雷的＂盒装警告＂,主要针对医师和患者提出建议,其内容包括：通过检测药物基因型以明确患者氯吡格雷的代谢变化,患者不良反应的风险,基因多态性对氯吡格雷的代谢及临床影响。     

Mucoid presentation of acute enterocolitis in children: a hospital-based case-control study

A hospital-based case-control study was carried out to clarify the characteristics of mucoid presentation of acute enterocolitis in children. One hundred sixty-eight cases of acute mucoid enterocolitis (study population) were compared with 200 cases of watery diarrhoea and 118 cases of blood dysentery (control groups) on the basis of clinical characteristics and findings on stool examination. Study and control groups were comparable with respect to age, body weight and nutritional status. There was no significant difference in clinical characteristics (duration of diarrhoea, stool frequency, presence of vomiting, fever and dehydration) between patients suffering from mucoid enterocolitis and blood dysentery. However, watery diarrhoea patients had significantly high frequencies of vomiting (p = 0.00001) and dehydration (p     

Intestinal permeability in kwashiorkor

Intestinal permeability can be assessed non-invasively using the lactulose-rhamnose (L-R) test, which is a reliable measure of small intestinal integrity. AIMS: To determine risk factors for abnormal intestinal permeability in kwashiorkor, and to measure changes in L-R ratios with inpatient rehabilitation. DESIGN: A case-control study of 149 kwashiorkor cases and 45 hospital controls. The L-R test was adapted to study kwashiorkor in Malawi, with testing at weekly intervals during nutritional rehabilitation. Urine sugars were measured by thin layer chromatography in London. RESULTS: The initial geometric mean L-R ratios (x100) (with 95% confidence interval) in kwashiorkor were 17.3 (15.0 to 19.8) compared with 7.0 (5.6 to 8.7) for controls. Normal ratios are < 5, so the high ratios in controls indicate tropical enteropathy syndrome. Abnormal permeability in kwashiorkor was associated with death, oliguria, sepsis, diarrhoea, wasting and young age. Diarrhoea and death were associated with both decreased L-rhamnose absorption (diminished absorptive surface area) and increased lactulose permeation (impaired barrier function) whereas nutritional wasting affected only L-rhamnose absorption. Despite, clinical recovery, mean L-R ratios improved little on treatment, with mean weekly ratios of 16.3 (14.0 to 19.0), 13.3 (11.1 to 15.9) and 14.4 (11.0 to 18.8). CONCLUSION: Abnormal intestinal permeability in kwashiorkor correlates with disease severity, and improves only slowly with nutritional rehabilitation.     

临床疑似TTP-HUS患者血浆置换治疗引起的并发症

由于采用血浆置换(PE)治疗血栓性血小板减少性紫癜溶血性尿毒综合征(TTP HUS)频率的增加,PE引起的并发症也成为制定治疗方案时需要考虑的因素。由于TTP HUS的诊断常常是不确定的,掌握PE治疗利弊之间的平衡已成为制定适当治疗方案的焦点。之前,我们于1996年～2002年间曾两次报道     

Two‐ and three‐dimensional prenatal sonographic diagnosis of prune‐belly syndrome

We report the prenatal diagnosis of 6 cases of Prune‐belly syndrome in the 2^nd trimester. The sonographic diagnosis was based on the findings of oligohydramnios, renal anomalies, and a lower abdominal cystic mass representing the abnormal dilatation of the bladder on conventional 2‐dimensional sonographic examination. We discuss the role of Doppler imaging and 3‐dimensional sonography as complementary methods to conventional sonography. Four of our 6 cases were confirmed with associated defects. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2010