幽门螺杆菌感染对功能性消化不良患者的自主神经功能和降钙素基因相关肽的影响

目的探讨幽门螺杆菌(H.pylori)感染对功能性消化不良(FD)患者自主神经功能和降钙素基因相关肽的影响。方法以符合罗马Ⅳ诊断标准的31例FD患者为研究对象,根据是否感染H.pylori将FD患者分为H.pylori+组和H.pylori-组,分别对两组患者进行消化不良症状指数(SID)、尼平消化不良指数(NDI)和医院焦虑抑郁量表的测评,并检测患者的心率变异性(HRV)及降钙素基因相关肽(CGRP)的表达。结果两组患者在SID(Z=-0.858,P=0.858)、NDI(Z=-1.464,P=0.143)和医院抑郁评分(Z=0.699,P=0.485)方面差异无统计学意义,但H.pylori+组患者的医院焦虑评分明显高于H.pylori-组(Z=-2.470,P=0.014)。H.pylori+组的CGRP水平为(0.999±0.274)ng/ml,明显高于H.pylori-组的(0.812±0.172)ng/ml(t=2.238,P=0.033)。两组患者的HRV在极低频率(t=-1.210,P=0.236)、低频功率(LF)(t=0.419,P=0.678)、高频功率(HF)(...     

Magnetic Resonance Imaging Findings in Patients with Tarsal Tunnel Syndrome

Tarsal tunnel syndrome (TTS) is a common entrapment syndrome whose diagnosis can be difficult. We compared preoperative magnetic resonance imaging (MRI) and operative findings in 23 consecutive TTS patients (28 sides) whose mean age was 74.5 years. The 1.5T MRI sequence was 3D T2* fat suppression. We compared the MRI findings with surgical records and intraoperative videos to evaluate them. MRI- and surgical findings revealed that a ganglion was involved on one side (3.6%), and the other 27 sides were diagnosed with idiopathic TTS. MRI visualized the nerve compression point on 23 sides (82.1%) but failed to reveal details required for surgical planning. During surgery of the other five sides (17.9%), three involved varices, and on one side each, there was connective tissue entrapment or nerve compression due to small vascular branch strangulation. MRI studies were useful for nerve compression due to a mass lesion or idiopathic factors. Although MRI revealed the compression site, it failed to identify the specific involvement of varices and small vessel branches and the presence of connective tissue entrapment.     

Efficacy of a nicotine nasal spray in smoking cessation: a placebo-controlled, double-blind trial

Laboratory trials have demonstrated the efficacy of nicotine replacement in smoking cessation bur absolute success races are low. For many, nicotine gum is hard to use and transdermal nicotine is slow-acting and passive. A new, faster-acting nicotine nasal spray (NNS) can provide easily self-administered relief from cigarette withdrawal. The NNS was tested for safely and efficacy in smoking cessation. Two hundred and fifty-five smokers were randomized to NNS or a piperine placebo. Drug use was limited to 8–32 doses/day for 6 months. Subjects were tested while smoking and at post-cessation daily (week 1) with follow-up at weeks 2, 3, 6 and at 3 months, 6 months and 1 year. Continuous abstinence analyses (CO ≤8 ppm.; no slips) showed that NNS significantly enhanced success rates over placebo overall (p < 0.001) and at all test intervals. Differences at key intervals between active and placebo were: 63% vs. 40% (day 5), 51% vs. 30% (week 3), 43% vs. 20% (6 weeks), 34% vs. 13% (3 months), 25% vs. 10% (6 months) and 18% vs. 8% (1 year). Side effects were common but tolerable. Cotinine measures showed that replacement of nicotine approximated 30% of smoking levels. Hazard functions revealed relapse risks peaked at day 1, day 5 and 3 weeks for strict abstinence. It is concluded NNS is safe, efficacious and a viable alternative treatment for smoking cessation.