Percutaneous transluminal angioplasty: the treatment of choice for renovascular hypertension due to fibromuscular dysplasia

Twenty-three renal artery stenoses in 21 hypertensive patients, caused by fibromuscular dysplasia, were treated with percutaneous transluminal angioplasty (PTA). Follow-up over a period of 1 to 30 months, including angiography, renal vein renin assay, and radionuclide flow studies, was performed in 8 patients, each with one stenosis. Dilatation was initially successful in all cases and was successfully repeated in 1 case. The mean systolic pressure decreased by 61.81 mm Hg and the mean diastolic pressure by 36.28 mm Hg in response to treatment. Thirteen patients were cured, 8 were felt to have better control of blood pressure on medication, and there was no failures. This study demonstrates that PTA is a clinically effective method of treating renovascular hypertension due to fibromuscular dysplasia.     

Congenital hepatic artery aneurysm simulating pancreatic carcinoma

The authors report a case of a hepatic artery aneurysm that simulated a mass in the head of the pancreas. The correct diagnosis was made preoperatively based on several findings: curvilinear calcification within the mass on CT, a well-defined cystic collection on ultrasound, absence of biliary duct dilatation or jaundice, and presence of other aneurysms.     

儿童失神性癫痫：乙琥胺优于丙戊酸和拉莫三嗪

儿童失神性癫痫为儿童期癫痫最常见的类型,通常使用乙琥胺、丙戊酸或拉莫三嗪治疗。但这三种常用药,哪种效果最佳且儿童最易耐受仍然未知,本研究对此进行了考察。     

乳腺癌术后化疗后放疗期间同期或序贯内分泌治疗的临床观察

目的 探讨乳腺癌术后化疗后放疗期间同期或序贯内分泌治疗的临床效果.方法 收集2003年1月～2007年1月本院行乳腺癌手术治疗且病理证明激素受体阳性的乳腺癌患者100例,将其分为同期组和序贯组,每组各50例.同期组给予化疗后放疗同期内分泌治疗,序贯组给予化疗后放疗序贯内分泌治疗.比较两组患者的临床疗效,随访统计两组患者毒副反应发生率及长期生存率.结果 同期组放射性肺炎、放射性肺纤维化、放射性皮肤纤维化发生率（分别为6.0％、10.0％、8.0％）与序贯组（分别为6.0％、8.0％、6.0％）比较,差异无统计学意义（P＞0.05）.同期组局部复发率（8.0％）、远处转移率（10.0％）及5年生存率（80.0％）与序贯组（分别为10.0％、14.0％、82.0％）比较,差异无统计学意义（P＞0.05）.结论 同期和序贯内分泌治疗并没有增加放疗的不良反应发生率,不会影响放疗的敏感性及总生存率.     

Intrahepatic regulatory T cells are phenotypically distinct from their peripheral counterparts in chronic HBV patients

Peripheral blood CD4+CD25+ regulatory T cells (Treg) prevent the development of strong HBV-specific T cell responses in vitro. In this study, we examined the phenotype of FoxP3+ regulatory T cells in the liver of patients with a chronic HBV infection. We showed that the liver contained a population of CD4+FoxP3+ cells that did not express CD25, while these cells were absent from peripheral blood. Interestingly, intrahepatic CD25-FoxP3+CD4+ T cells demonstrated lower expression of HLA-DR and CTLA-4 as compared to their CD25+ counterparts. Patients with a high viral load have a higher proportion of regulatory T cells in the liver, but not in blood, compared to patients with a low viral load. In conclusion, the intrahepatic Treg are phenotypically distinct from peripheral blood Treg. Our data suggest that the higher proportion of intrahepatic Treg observed in patients with a high viral load may explain the lack of control of viral replication.