Promise of Urinary Nerve Growth Factor for Assessment of Overactive Bladder Syndrome

Overactive bladder syndrome (OAB) is highly prevalent bladder disorder in men and women. About 10–15% of the population suffers from urgency frequency with or without urgency urinary incontinence. It is estimated that 50–75% of patients with OAB may have urodynamic detrusor overactivity (DO). Urodynamic study invasive and most of the OAB patients might not accept it as a routine assessment. Therefore, a more objective and non‐invasive test for diagnosis and assessing DO from OAB patients is needed. Recently, urinary nerve growth factor (NGF) has gained great interest in detecting DO in patients with OAB. Urinary NGF level was found to increase in OAB and urodynamic DO. Urinary NGF levels correlated with severity of OAB symptoms. Patients with either idiopathic or neurogenic DO may have increased urinary NGF levels. Urinary NGF levels have been shown to decrease in patients with patients with OAB and DO who have been well treated with antimuscarinics or botulinum toxin injection, but not in those with persistent OAB after treatment. Not all patients with OAB can have an elevated urinary NGF level; it may also be increased in patients with interstitial cystitis/painful bladder syndrome and other lower urinary tract diseases, suggesting urinary NGF expression could be a product of bladder inflammation and a limited specificity of urinary NGF for diagnosing DO. The source of urinary NGF has not yet been fully explored yet. Nevertheless, urinary NGF level is likely to be a promising biomarker for diagnosis of DO from OAB patients, to monitor therapeutic outcome and predict disease progression.     

The role of colonoscopy in screening persons with family history of colorectal cancer

Abstract First-degree relatives of colorectal cancer patients are at increased risk for developing colorectal neoplasms. In order to assess the potentiality of colonoscopy screening in this high-risk population, 213 asymptomatic family members (age range 30-69 years, mean 42.8 years) of those patients with colorectal cancer received colonoscopic examination at Chang-Gung Memorial Hospital from April 1992 to May 1994. Twenty-eight persons with 42 lesions (polyps or cancer) were identified, including 28 adenomas, nine hyperplastic polyps and five adenocarcinomas. The positive detection rate was 9.9% for adenoma and 2.3% for cancer. Colorectal neoplasms afflicted males more frequently than females (16.7 vs 5.7%, P < 0.05) and occurred less frequently in those < 40 years of age (5.5 vs 17.2%, P < 0.05). Forty-two per cent of the detected neoplastic lesions were beyond the reach of 60 cm flexible sigmoidoscopy and 36% of adenomas were < 0.5 cm in size and would be missed if patients were screened by air contrast barium enema. Cost analysis revealed that the charges of both screening colonoscopy and screening flexible sigmoidoscopy/air contrast barium enema were approximate. Colonoscopy also has a high acceptability and safety. It appears appropriate to use colonoscopy, rather than flexible sigmoidoscopy or air contrast barium enema, as an initial screening procedure for persons with a family history of colorectal cancer, especially those > 40 years of age.     

Iron status and cardiovascular risk factors in patients with haemodialysis versus patients with ischaemic heart disease

Aim:   The study aimed to investigate whether imbalanced iron status in patients with haemodialysis coexisted with abnormal lipid profile, higher inflammatory status and altered growth hormone–insulin-like growth factor (GH–IGF)-I axis and to compare these biochemical markers with patients with ischaemic heart disease.
Methods:   Serum samples for biochemical and immunological analyses were collected from 74 normal subjects, 138 patients with ischaemic heart disease (IHD) and 115 patients on haemodialysis (HD).
Results:   Compared with normal subjects, lower serum iron, lower total iron-binding capacity (TIBC) and higher ferritin in HD patients coexisted with decreases in high-density lipoprotein cholesterol and total bilirubin as well as increases in lactate dehydrogenase (LDH), interleukin (IL)-6, C-reactive protein (CRP) and IL-10. Decreased IGF-I and increased GH were found in HD patients whereas unchanged GH–IGF axis were found in IHD patients. Compared with IHD, much higher ferritin, lower TIBC, lower bilirubin and higher LDH levels were found in HD patients.
Conclusion:   Imbalanced iron status in patients on HD coexisted with abnormal lipid profiles, increased anaerobic activity and higher inflammatory status, which suggests that imbalanced iron status in HD patients may play a deleterious role in cardiovascular pathophysiology. Altered GH–IGF axis found in HD patients was more obvious than in IHD patients. This may imply that the GH–IGF axis system is modulated or adapted by HD.     

小儿甲型副伤寒29例临床分析

目的：探讨小儿甲型副伤寒的临床特征。方法：分析29例病例资料的临床表现，实验室资料、发病特点、诊断、治疗要点及其流行特征。结果：本组病例以农村儿童为多发病例，发病年龄主要集中在2—10岁之间，临床以发热为主要表现，呈稽留热和驰张热型；消化道症状较轻；感染中毒症状，相对缓脉，玫瑰疹少见；外周血白细胞与嗜酸性粒细胞减少。血培养是明确诊断最主要的方法之一。头孢类和氨基糖甙类为敏感药物。结论：甲型副伤寒，临床未显现典型的消化造症状及体征，用药应以药物敏感试验为指导，避免滥用抗生素。     

Green dragon swaying its tail and white tiger shaking its head manipulation on Bāliáo () for constipation

Conventional Bāliáo (

) was used to treat constipation, green dragon swaying its tail and white tiger shaking its head manipulation was applied and sound effect was found.