短程兰索拉唑、克拉霉素和阿莫西林三联疗法根除幽门螺杆菌在东南亚患者中的

测定和比较含兰索拉唑、克拉霉和阿莫西林的5日tid疗法和7日bid疗法根除幽门螺杆菌（H.pylori)疗效,方法：本研究为随机,双盲,对照研究。胃窦和胃体部活检经组织学检查和快速尿素酶试验确诊为H．pylori感染的患者内入研究,患者分别接受克拉霉素500mgtid,阿莫西林500mgtid和兰索拉唑每日30mg治疗5天（LAC5组）或克拉霉素500mgbid,阿莫西林500mgbid和兰索拉唑每日30mg治疗7天（LAC7组）。治疗结束至少4周后,用组织学检查和快速尿酶素试验评估H．pylori是否成功除,胃窦和胃体部活检H．pylori阴性定义为H．pylor根除,结果：108例胃患者纳入研究,LAC5组有4例患者失访;LAC7组2例患者失访,2例患者对药物不能依从。按意图治疗分析,LAC5组的根除率为85．2％[46/54,95%可信区间（CI):72.9%,93.4%],LAC7组的根除率为87．0％（47／54,95％CI：75．1,94.6%).按方案分析,LAC5组的根除率为92．90％（46／50,95％CI：80．8％,97．8％）,LAC7组的根除率为94．0％（47／50,95％CI：83.5%,98.7%),两种疗效对患者均很适宜,除LAC7组2例外,其余患者均服完规定的药物,两种疗法的副作用均较轻微,没有患者因对药物不耐受而中断治疗,最常见的副作用是味觉改变（LAC5组：64．7％,LAC7组：78．8％）。少数患者有腹泻,恶心和厌食,结论：LAC5tid疗法和LAC7bid疗法均有具有良好受性的治疗方案,根除H．pylor的疗效高。     

慢性胃病脾虚患者胃窦粘膜胃泌素细胞和分泌生长抑素细胞的变化及其意义

目的：观察以慢性胃病为主的脾虚患者胃窦粘膜分泌胃泌家(Gas)细胞(G细胞)、生长抑素(SS)细胞(D细胞)与脾虚证发生的关系。方法：将84例脾虚患者分为脾胃虚寒组、脾虚夹热组、胃阴不足组、脾胃湿热组、肝胃不和组，应用免疫组化技术标记胃窦粘膜G、D细胞，并定量分析。结果：以慢性胃病为主的脾虚证患者G、D细胞数均减少，D细胞面积缩小，G/D细胞数和细胞面积比值均增高(P＜0．05)。结论：G、D细胞的变化可能是慢性胃病脾虚证胃肠功能障碍的一个重要病理机制。     

Radiographic damage in large joints in early rheumatoid arthritis: relationship with radiographic damage in hands and feet, disease activity, and physical disability

An assessment of the onset of radiographic damage in the large joints (hip, knees, shoulders, elbows, ankles and tarsus) in patients with early rheumatoid arthritis, and the relationship of the progression of large joint damage with joint damage in hands and feet, with physical disability, and with cumulative disease activity, was performed in a prospective 6 yr follow-up study. Large joint damage appeared to be an early phenomenon with 20% of the patients having some damage in at least one large joint within 1 yr, and 50% of the patients within 6 yr after disease onset. Radiographic damage in large joints was significantly related to the damage in hands and feet, the physical disability index, and the cumulative disease activity. The initial disease activity at study entry was the only prognostic factor that reached significance.      

Interleukin-12 inhibits murine graft-versus-host disease

Interleukin-12 (IL-12) is a potent immunostimulatory cytokine and an inducer of type-1 T-helper cell activity and of cytotoxic T lymphocyte and natural killer cell function. We report here the paradoxical observation that a single injection of 4,900 IU of recombinant murine IL-12 inhibits acute graft-versus-host disease (GVHD) in a fully major histocompatibility complex (MHC) plus multiple minor antigen-mismatched bone marrow transplantation (BMT) model (A/J-->B10). The protective effect was enhanced by administration of T-cell-depleted host-type BM cells, and complete donor-type lymphohematopoietic reconstitution was observed in most animals. Treatment with a protective course of IL-12 led to increased serum interferon-gamma (IFN-gamma) levels as compared with those for GVHD controls at early time points, when IFN-gamma was produced predominantly by host-type natural killer cells, but led to almost complete inhibition of the later GVHD-associated increase in serum IFN-gamma levels, when IFN-gamma is produced predominantly by CD4+ T cells. Furthermore, IL-12 treatment was associated with marked alterations in the kinetics of donor T-cell expansion. Reductions in donor CD4+ and CD8+ T cells were observed in the spleen on day 4 post- BMT, but a marked increase in donor CD8+ cells was observed on day 7. Unlike broadly immunosuppressive methods for inhibiting GVHD, which are associated with loss of antileukemic effects, IL-12 has the potential to mediate antileukemic effects of its own; therefore, the GVHD- inhibitory effects of IL-12 described here suggest a potential application for this cytokine in clinical BMT.     

Temporomandibular joint: comparison of single- and double-contrast arthrography

Lower-space, single-contrast arthrography and dual-space, double-contrast arthrotomography were sequentially applied to 58 fresh temporomandibular joint (TMJ) autopsy specimens, and the findings were compared with observations in corresponding cryosections. Both modalities had high accuracy rates (greater than or equal to 84%) and no statistically significant differences between the two techniques were found. A side-by-side comparison of the two types of arthrograms, however, revealed that video tape recording of lower-space, single-contrast arthrography was superior in demonstrating joint dynamics and that dual-space, double-contrast arthrotomography was superior in demonstrating the soft-tissue anatomic features of the joint. It appears that lower-space, single-contrast arthrography can be recommended for examination of patients with clicking, catching, and intermittent locking, and that dual-space, double-contrast arthrotomography is preferable when information about morphologic alterations is clinically more important than information about joint dynamics.     

Combined surgical and radiologic intervention for complicated cholelithiasis in high-risk patients

Ultrasound-guided surgical cholecystostomy with local infiltration anesthesia was combined with radiologic removal of gallstones in 36 elderly patients with acute calculous gallbladder disease who were considered to be at high risk due to multiple coexisting diseases. At cholecystostomy, the fundus of the gallbladder was sutured to the anterior abdominal wall resulting in a short surgical track to the gallbladder. This permitted early percutaneous stone removal through the cholecystostomy track under fluoroscopic guidance. All gallstones were removed in 31 of 36 patients, for an overall success rate of 86%. The success rate was 97% for gallbladder stones, 86% for cystic duct stones, and 63% for common bile duct stones that were removed by traversing the cystic duct. The treatment in the five patients in whom radiologic stone removal was incomplete or unsuccessful consisted of elective cholecystectomy in three, with common bile duct exploration in two of these; endoscopic sphincterotomy and stone extraction in one; and expectant management in one. There were no deaths or serious complications. This technique has thus proved safe and effective in these 36 high-risk patients.     

Cerebral astrocytomas: histopathologic correlation of MR and CT contrast enhancement with stereotactic biopsy

Gadolinium-labeled diethylenetriaminepentaacetic acid was used as a contrast agent for stereotactic magnetic resonance (MR) imaging in six selected patients with brain tumors who underwent stereotactic biopsy. Regions of contrast enhancement demonstrated by computed tomography (CT) and MR imaging in four of the six patients correlated with areas of malignant neovascularity and endothelial proliferation within solid tumor. Radiation necrosis produced contrast enhancement indistinguishable from that of recurrent neoplasm. Isolated tumor cells within intact white matter were identified in biopsy specimens obtained outside of regions that were depicted as abnormal by contrast material-enhanced CT, as well as by precontrast and postcontrast T1- and T2-weighted MR images.