Trends in etiologies of chronic pancreatitis within 20 years: analysis of 636 cases

Background  The prevalence of chronic pancreatitis has increased during recent years in Asia-Pacific areas as well as in China. The etiologies vary in different regions and periods. This study aimed to investigate the changing etiologies of chronic pancreatitis within 20 years at Peking Union Medical College Hospital in China.

Methods  Retrospective analysis of the etiologies of 636 cases of chronic pancreatitis at Peking Union Medical College Hospital from 1990 to 2010 was performed. Patients were divided into two groups according to two time periods (1990–2000 and 2001–2010). Statistical analysis was performed using the chi-square test.

Results  The morbidity rate of chronic pancreatitis in China has recently increased. The main etiology changed from biliary diseases in the 1990s (decreased from 36.8% to 28.1%) to alcohol abuse after the year 2000 (increased from 26.5% to 36.8%). The main etiology of biliary diseases is stones in the cholecyst or bile duct, and the percentage of cholecystitis cases has increased. Autoimmune disease, including autoimmune pancreatitis, has increased quickly and currently accounts for 7.3% of cases because a greater number of autoimmune pancreatitis cases are being diagnosed. Approximately 9.5% of chronic pancreatitis cases are caused by multiple factors such as alcohol abuse and bile duct stones. Other factors include cholecystectomy and acute pancreatitis.

Conclusions  The main etiology of chronic pancreatitis has changed from biliary disease to alcohol abuse in recent years. Autoimmune factors have also obviously increased.

     

水飞蓟宾口服微乳制备及性质评价

目的 制备稳定的水飞蓟宾口服微乳.方法 采用测定表面张力、绘制拟三元相图和正交设计相结合的方法 进行处方筛选及工艺优化.结果 鉴别了微乳类型,用光子相关光度法测定了微乳的平均粒径,并且用超速离心法测定了药物在微乳中的相分布.经过对微乳进行离心及影响因素实验,结果 表明该微乳在室温下3个月内能维持均一稳定,并且受高温光照影响较小.结论 该处方制备的水飞蓟宾口服微乳外观及稳定性良好,为进一步研究奠定了基础.     

布比卡因通过组织蛋白酶B激活NLRP3炎性体诱导N2a细胞毒性

目的:探讨组织蛋白酶B及NLRP3炎性体在布比卡因诱导N2a细胞神经毒性中的作用及分子机制.方法:将N2a细胞随机分为4组进行干预,空白对照组(C组):完全培养基培养,无任何药物干预;单纯抑制剂组(CA组):10 μmnol/L的CA-074-me预处理1h后不加任何药物处理;CTSB抑制剂预处理+布比卡因组(CA+B...     

恩替卡韦与拉米夫定治疗HBeAg阴性慢性乙型肝炎的对照研究

Ⅱ期临床试验已经证实恩替卡韦是一种治疗HBeAg阴性慢性乙型肝炎有效和可选择的抗病毒药物。采用双盲法将648例未曾接受过核苷类药物治疗的HBeAg阴性慢性乙型肝炎随机分配进入恩替卡韦（0．5mg／d）治疗组或拉米夫定（100mg／d）治疗组，疗程至少52wk。     

The prognostic role of diabetes mellitus type 2 in the setting of hepatocellular carcinoma: a systematic review and meta-analysis

AimTo evaluate the effect of diabetes mellitus type 2 (T2DM) on the outcomes after treatment of hepatocellular carcinoma (HCC).MethodsPubMed and Cochrane Central Register of Controlled Trials Databases were systematically searched. Three HCC clinical outcomes were explored: death, progressive disease after locoregional therapies, and recurrence. Sub-analysis was performed according to the use of potentially curative (resection, transplantation, termo-ablation) or non-curative therapies. Odds ratios (OR) and 95% confidence intervals (CI) were calculated to compare the pooled data between T2DM and non-T2DM groups.ResultsA total of 27 studies were analyzed. Overall, 85.2% of articles were from Asia. T2MD was associated with an increased risk of death (OR 3.60; 95%CI 2.18-5.95; P < 0.001), irrespective of the treatment approach: curative (OR 1.30 95%CI 1.09-1.54; P = 0.003) or non-curative (OR 1.05; 95%CI 1.00-1.10; P = 0.045), increased HCC recurrence (OR 1.30; 95%CI 1.03-1.63; P = 0.03), and increased disease progressiveness (OR 1.24; 95%CI 1.09-1.41; P = 0.001).ConclusionsCurrent data provide strong evidence that T2DM unfavorably affects HCC progression and recurrence, and patients'' survival after treatment, irrespective of the approach used.

The prevalence of hepatocellular carcinoma (HCC) associated with non-alcoholic fatty liver disease (NAFLD) is increasing (1,2) as the result of the globally increased prevalence of NALFD, which is estimated to be about 25% (3). NAFLD patients have a two- to three-fold increase in the risk of developing diabetes mellitus type 2 (T2DM), and the risk is even higher in those with more severe hepatic disease and fibrosis (4-6). On the other hand, patients with T2DM have a higher prevalence of non-alcoholic steatohepatitis (NASH), liver fibrosis, and end-stage liver disease (7).Several studies have documented the relation between T2DM and the incidence of different cancer types, while the data on the relationship between T2DM and increased risk of incident HCC seem especially robust and clinically reliable (8-10). Observational studies suggest higher mortality of patients developing HCC in the presence of T2DM (11,12). On the other hand, data from meta-analyses suggest that both the risk and prognosis of patients with HCC and diabetes might be influenced by the type of anti-diabetic treatment, where metformin, unlike sulphonylurea, potentially protects against cancer and leads to better prognosis in case of cancer development (13,14).The underlying mechanisms linking T2DM and HCC are still under scientific scrutiny. However, the interconnections between metabolic derangements characteristic for T2DM, obesity, and NAFLD suggest that insulin resistance on the hepatic and systemic level and the release of pro-inflammatory cytokines, vasoactive factors, and pro-oxidant molecules are potentially implicated in the development and progression of HCC.With the intent to gain a better insight into this issue, we performed a meta-analysis to evaluate the effect of T2DM on poor outcomes after HCC treatment. To explore several different clinical settings, three outcomes of interest were investigated: death, progressive disease after locoregional therapies, and recurrence. Moreover, sub-analyses were performed according to the use of potentially curative (resection, transplantation, termo-ablation) or non-curative therapies.     

Aldosterone biosynthesis in extraadrenal tissues

ＯｂｊｅｃｔｉｖｅＴｏｄｅｔｅｒｍｉｎｅｗｈｅｔｈｅｒｅｘｔｒａａｄｒｅｎａｌｔｉｓｓｕｅｓｓｙｎｔｈｅｓｉｚｅａｌｄｏｓｔｅｒｏｎｅｉｎａｄｄｉｔｉｏｎｔｏｖａｓｃｕｌａｒｔｉｓｓｕｅａｎｄｂｒａｉｎ．ＭｅｔｈｏｄｓＥｘｖｉｖｏｋｉｄｎｅｙｐｅｒｆ...     

广西地区50975例孕妇无创产前筛查分析

目的 探讨无创产前筛查(NIPS)在胎儿染色体非整倍体异常(CAA)及全基因组拷贝数变异(CNV)筛查中的临床应用价值.方法 选择2018年1月至2019年12月,广西壮族自治区60余家医疗机构采集血液样本后送至本院完成NIPS的50975例单胎孕妇为研究对象.其分娩年龄为13～54岁,高龄孕妇(分娩时年龄≥35岁)为...     

微创经皮膀胱取石术(附22例报告)

目的 探讨微创经皮膀胱气压弹道碎石适应症、操作方法、疗效等.方法 回顾我院近两年来采取微创经皮膀胱碎石取石术治疗膀胱结石患者22例的临床资料.结果 22例患者中小儿膀胱结石5例,男性成人17例;小儿结石直径均在2.6cm以上,成人结石直径为2～5cm,多发性结石18例.均一次取尽结石,住院3～8d,平均住院4.5d,术中术后均无严重并发症.结论 微创经皮膀胱碎石取石术适应于复杂性结石的患者,具有取石成功率高,并发症少,操作方法简单、安全之优点.     

血瘀证患者的血液动力学观察

本文通过对14名心血管病血瘀证患者血液动力学观察,北与非血瘀证患者(n=29)及正常对照组(n=24)比较,表明血瘀证患者的血液动力学改变乃以后负荷加重为特征,而不表现为心脏收缩功能的减退。该改变与血瘀证的血液流变性异常具有相同的意义。与已有的关于心气虛表现为左心收缩功能减退的研究结论相联系,似可认为,由负荷加重,最终累及心脏收缩功能减退为血瘀向气虚血瘀转化的病理生理基础。