Synovial fluid phospholipase A2s and inflammation.

The activation of phospholipase A2 is believed to have an important role in the inflammatory process owing to its induction of eicosanoids, platelet activating factor, and other mediators. Soluble phospholipase A2 has been associated with exudates in different inflammatory conditions. In this review the general physiology and control of this enzyme and, in particular, the most recent findings on human synovial fluid phospholipase A2s are discussed.     

术后胆漏和继发胆管狭窄的内镜治疗

胆漏和继发胆管狭窄是严重的外科并发症，传统的治疗方法是再次开腹手术，但再手术并发症多，死亡率高。而内镜胆管造影不仅可明确诊断，且内镜下治疗具有安全、疗效肯定、创伤小和并发症少等优点，可作为大多数胆漏和胆管狭窄患者首选治疗方法。     

BIPAP无创呼吸机操作原理及使用

本文着重介绍了BIPAP无创呼吸机操作原理及基本使用原则.为了防止概念混淆,特别对英文缩写同为BIPAP的双相气道正压通气作了简要的对比说明.     

成人水痘20例临床分析

目的探讨成人水痘的临床特点。方法分析20例成人水痘的临床特点，并与30例儿童水痘比较。结果患者出疹时间、皮疹分布区域、发热时间和并发症等，成人水痘都与儿童水痘不同。结论与儿童水痘相比较，成人水痘有自己的临床特点。     

氢氧化钙预防根管治疗期间急症的临床观察

目的 观察氢氧化钙根管内封药对预防根管治疗期间急症的临床疗效。方法 使用氢氧化钙及传统根管内消毒药物樟脑对氯酚、甲醛甲酚根管内封药，观察疼痛指数并比较其根管治疗期间急症的发生率。结果 氢氧化钙封药后根管治疗期间急症的发生率最低，与传统药物相比，其差异有统计学意义。结论 氢氧化钙根管内封药。对预防根管治疗期间的急症有较好的作用。     

儿童胡桃夹征CT表现(附2例报告)

“胡桃夹征”(nutcracker sign)又称“左肾静脉压迫综合征”,本文对经CT证实的2例分析如下。1材料与方法2例中,男女各1例,年龄7~10岁。临床症状主要为反复血尿,直立或剧烈活动明显。症状持续时间为10天~1年2个月,为肉眼或镜下血悄,伴有或不伴蛋白尿,无高血压及水肿。2例患者实验室检查:肝功、肾功、抗PPD抗体、抗“O”均正常。2结果2例患者重组图像均显示肠系膜上动脉(SMA)与腹主动脉夹角变小,为23°~25°,SMA向后挤压左肾静脉,以矢状面重组图像较为直观(图1);左肾静脉于SMA后方与腹主动脉之间明显狭窄,其远侧段管腔扩张(图2)。CTA…     

Pesticide assessment: Protecting public health on the home turf

Pesticide regulation is examined in the context of Health Canada’s Pest Management Regulatory Agency’s assessment of the chlorophenoxy herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) for turf. 2,4-D is the most common herbicide used to kill weeds in grass.The medical literature does not uniformly indicate harms from herbicides. However, the balance of epidemiological research suggests that 2,4-D can be persuasively linked to cancers, neurological impairment and reproductive problems. These may arise from 2,4-D itself, from breakdown products or dioxin contamination, or from a combination of chemicals.Regulators rely largely on toxicology, but experiments may not replicate exposures from 2,4-D application to lawns because environmental breakdown products (eg, 2,4-dichlorophenol) may not accumulate and selected herbicides are possibly less contaminated. Dioxins are bioaccumulative chemicals that may cause cancer, harm neurological development, impair reproduction, disrupt the endocrine system and alter immune function. No dioxin analyses were submitted to the Pest Management Regulatory Agency, and the principal contaminants of 2,4-D are not among the 17 congeners covered in pesticide regulation. Independent assessment of all dioxins is needed, in tissues and in the environment.The 2,4-D assessment does not approach standards for ethics, rigour or transparency in medical research. Canada needs a stronger regulator for pesticides. Potentially toxic chemicals should not be registered when more benign solutions exist, risks are not clearly quantifiable or potential risks outweigh benefits. Until landscaping pesticides are curtailed nationally, local bylaws and Quebec’s Pesticide Code are prudent measures to protect public health. Physicians have a role in public education regarding pesticides.