At the heart of the problem: congestive cardiac failure as a cause of ascites: A narrative review

Heart failure leading to cardiac ascites is an extremely rare and underrecognized entity in clinical practice. Recognizing cardiac ascites can be difficult, especially since patients presenting with ascites may have more than 1 etiology. Various biomarkers are available to aid in the diagnosis of cardiac ascites, though with differing sensitivities and specificities. Such biomarkers include serum albumin, ascitic albumin and protein, as well as serum N-terminal pro-brain natriuretic peptide (NT-proBNP). While serum NT-proBNP is a powerful biomarker in distinguishing the etiology of ascites and monitoring treatment progression, its cost can be prohibitive in low-resource settings. Clinicians practicing under these circumstances may opt to rely on other parameters to manage their patients. We go on further to report a series of 3 patients with cardiac ascites to illustrate how these biomarkers may be employed in the management of this patient population. Clinicians should always keep in mind the differential diagnosis of cardiac failure as a cause of ascites. The resolution of cardiac ascites may serve as a surrogate clinical marker for response to antifailure therapy in lieu of NT-proBNP at resource-scarce centers.     

应用桌上型全自动腹膜透析机的护理体会

桌上型全自动腹膜透析机是一种自动控制透析液循环进出腹腔的机器,由电脑控制,可自动持续地进行各种方式的腹透,并由电脑操作、监测、记录每次的灌注量、停留时间、引流时间、流出量及透析液温度。它具有操作简单、安全等特点,更重要的是减少了交换透析液过程中的大量手工操作,降低了感染机会,使腹膜炎的发生率明显下降。我科2006年6月27日收治了1例拟行腹膜透析治疗的患者,并于2006年9月16日开始利用全自动腹膜透析机行腹膜透析治疗5月余,血肌酐水平控制较稳定,收到较好效果,现将护理体会介绍如下。病例介绍患者,男性,75岁,因晨起排便后出…     

脑室-腹腔分流术治疗正常压力脑积水的临床预后因素分析

目的研究影响正常压力脑积水（NPH）行脑室-腹腔分流手术预后的因素。方法从NPH患者的症状、病因、分流管的选择及腰穿放液试验、影像学表现、病程、年龄等因素分析手术效果。结果蛛网膜下腔出血、颅脑外伤、脑瘤术后引起的NPH手术效果好;临床以步态不稳为主要症状的手术效果好;选用低压分流管、腰穿放液试验症状改善的手术效果好;CT平扫脑室旁低密度区（PVL）和MRI检查室周、皮质下高信号的手术效果好;病程〈6个月、年龄〈60岁的手术效果好。结论影响NPH行脑室-腹腔分流手术预后的因素复杂,综合分析各因素对判断手术预后非常有益。     

A Young Patient with Microscopic Polyangiitis Requiring Hemodialysis with Complications of Repeated Episodes of Posterior Reversible Encephalopathy Syndrome Probably Due to Different Etiologies

A young woman with microscopic polyangiitis (MPA) requiring hemodialysis showed repeated posterior reversible encephalopathy syndrome (PRES) with spatiotemporal multiple lesions over a period of two months. The first PRES episode with confusion and the second PRES episode with vertigo and nausea were caused by MPA, hypertension and renal failure. These symptoms were improved by the reinforcement of MPA treatment and blood pressure management. The third PRES episode with nausea, headache, seizure and visual changes was induced by rituximab infusion and hypertension. The PRES was improved with blood pressure and convulsant management. These conditions are challenging to diagnose and treat.     

经血宁胶囊正丁醇提取部位抗炎作用研究

目的:研究经血宁胶囊正丁醇提取部位(JXN-C)的抗炎作用.方法:动物随机分为JXN-C高剂量和低剂量组(生药9,4.5 g·kg-1),阳性对照组(地塞米松3 mg· kg-1),空白对照组,均ig给药.复制角叉菜胶致大鼠足肿模型,容积测量法测定足跖肿胀度并计算抑制率,测定致炎大鼠血清炎症因子一氧化氮(NO)水平.复制二甲苯致小鼠耳廓肿胀模型,测定耳廓肿胀度和计算抑制率.腹腔染料渗出法测定腹腔洗出液吸光度(A).结果:JXN-C 4.5 g·kg-1给药后120,180 min对角叉菜胶致炎大鼠足跖肿胀有较明显的抑制作用(P＜0.05),JXN-C 9 g·kg-1可降低角叉菜胶致炎大鼠血清中NO水平(P＜0.05).JXN-C对二甲苯所致的小鼠耳廓肿胀也有较明显的抑制作用(P＜0.05),高、低剂量的抑制率分别为52.12％及45.56％.对冰醋酸所致小鼠腹腔毛细血管通透性增加无抑制作用.结论:JXN-C具有较好的抗炎作用,抗炎机制之一可能与其抑制NO参与炎症反应过程有关.     

齐墩果酸在人血浆蛋白和血清白蛋白中结合率的测定

齐墩果酸(oleanolic acid,OA)又名庆四素(图1),系五环三萜类化合物,以游离或结合成苷的形式广泛存在于白花蛇舌草、山楂、丁香、大枣、女贞子、枇杷叶、橡木和夏枯草等植物中。临床上主要用于急     

腹腔冲洗液中FGF2表达改变与子宫内膜异位症的关系

目的检测FGF2蛋白在子宫内膜异位症(EMs)患者及非内异症患者腹腔冲洗液中的表达,探讨其在EMs发生、发展中的作用。方法采用酶联免疫吸附试验(ELISA)检测45例子宫内异症患者(EMs组)及40例非内异症患者(对照组)腹腔冲洗液中FGF2水平。结果 (1)在EMs组中,FGF2水平分别为(126.67±39.26)ng·L-1,均高于对照组的(50.31±27.33)ng·L-1,差异具有显著性(P<0.01);(2)在EMs组中,Ⅲ～Ⅳ期患者的FGF2水平为(118.75±45.81)ng·L-1,高于I～Ⅱ期患者的(90.43±22.05)ng·L-1(P<0.05)。结论腹腔冲洗液中FGF2增加可能与EMs发病及发展有关。     

异鼠李素-3-O-新橙皮糖苷与牛血清蛋白的结合及分子对接研究

目的： 研究异鼠李素-3-O-新橙皮糖苷与牛血清蛋白的相互作用。 方法： 采用平衡透析法,高效液相色谱测定异鼠李素-3-O-新橙皮糖苷与牛血清蛋白的结合率。采用同源建模和分子对接技术分析药物相互作用模式。 结果： 异鼠李素-3-O-新橙皮糖苷与牛血清蛋白的最佳平衡透析时间为16 h,异鼠李素-3-O-新橙皮糖苷低、中、高（2,4,8 mg·L^-1）3个质量浓度的牛血清蛋白结合率分别为（43.23±2.23）%,（45.16±3.12）%,（44.71±3.25）%。牛血清白蛋白同源建模和分子对接结果显示：异鼠李素-3-O-新橙皮糖苷能够与牛血清白蛋白氨基酸残基形成6个氢键。 结论： 异鼠李素-3-O-新橙皮糖苷与牛血清发生中等强度的结合。     

The effects of Morinda citrifolia L. (noni) on the immune system: its molecular mechanisms of action

The aim of this study was to investigate the mechanisms involved in the immunomodulatory effects of Morinda citrifolia L. (noni) in vitro and in vivo in mice. In vitro, Tahitian Noni Juice (TNJ) and Noni fruit juice concentrates (NFJC) (1, 5mg/mL) potently activate cannabinoid 2 (CB2), but inhibit cannabinoid 1 (CB1) receptors in a concentration-dependant manner. In vivo, oral administration of TNJ ad libitum for 16 days decreased the production of IL-4, but increased the production of IFN-gamma. These results suggest that noni modulates the immune system via activating of the CB2 receptors, and suppressing of the IL-4, but increasing the production of IFN-gamma cytokines. It may also exert beneficial immunomodulation effects in conditions involving inadequate immune responses.     

用脑内透析法测定人参茎叶皂甙及其单体对大鼠纹状体DOPAC、HVA及5-HIAA的影响

用脑内透析法结合高效液相——电化学检测技术的研究发现人参茎叶皂式和单体皂甙Rg_1、Rh_1可显著降低清醒自由活动大鼠脑纹状体细胞外液中DOPAC和HVA的含量,而对5-HIAA却无显著影响。Rg_2和Re对DOPAC、HVA和5-HIAA则均无显著影响。