Relationship between urinary sodium excretion and pioglitazone‐induced edema

To investigate the factors contributing to pioglitazone‐induced edema, we analyzed sodium excretion and several clinical parameters before and after administration of pioglitazone. We analyzed these parameters before and after 8 weeks of administration of pioglitazone to female subjects with type 2 diabetes. When we evaluated whether a significant correlation was found between salt excretion and blood pressure, six patients showed such correlation and 20 patients did not. After 8 weeks of pioglitazone administration, five patients had developed edema, and, surprisingly, such correlation was not found in all five subjects. Salt excretion after administration of pioglitazone was significantly lower in subjects who developed edema and those who showed the correlation, and the hematocrit was significantly lower after administration in the subjects who showed the correlation, but not in the edema group. Pioglitazone‐induced edema would be caused not only by fluid retention, but also by other factors, such as vascular permeability. (J Diabetes Invest, doi: 10.1111/ j.2040‐1124.2010.00046.x, 2010)     

内板切除在包皮环切术中的应用及评价

目的探讨内板切除法在包皮环切术中的应用及疗效评价。方法对96例包皮过长患者采用内板切除法行包皮环切术;同期对108例患者采用传统手术方法,对两组术后出血、感染、系带水肿及阴茎外形满意度进行对比。结果两组术后出血均为2例（P〉O．05）两组术后均无感染发生。内板切除组术后发生2例系带水肿,而传统手术组术后22例系带水肿．两组的差异有统计学意义（P〈0．01）。内板切除组阴茎外形满意度96．9％,传统手术组为89．8％,两组的差异有统计学意义（P〈O．05）。结论内板切除应用于包皮环切术疗效理想,优于传统手术。     

149例重症手足口病患儿临床分析

目的探讨重症手足口病（HFMD）的临床特征、分型和处置方案,提高重症HFMD患者的治愈率和生存率。方法对149例重症HFMD患儿的流行病学、临床表现、病情动态变化、实验室检查及物理检查、治疗及转归进行回顾性分析。结果 149例重症HFMD患儿,男98例（65.8%）,女51例（34.2%）;年龄5个月～13岁,﹤3岁者92例（61.7%）,平均年龄3.3岁。依据临床表现及并发症分为两组：Ⅰ组,并发症以神经系统症状为主要表现者,140例（94%）,均存活;Ⅱ组,并发神经、循环、呼吸等系统多器官损害者,9例（6%）,3例死亡。存活患儿目前无后遗症出现。结论 HFMD重症病例分为重型和危重型两型,危重型可引起死亡。在临床工作中密切监测,及时发现危重型倾向的病例,正确及时治疗,能提高重症HFMD患儿的生存率,减少并发症和后遗症,改善生存质量。     

消瘀康胶囊对中小量高血压性脑血患者血肿周围水肿及神经功能的影响

目的 探讨消瘀康胶囊对中小量高血压性脑出血患者血肿周围水肿及神经功能的影响.方法 将70例中小量高血压性脑出血患者分为治疗组和对照组,两组均给予常规治疗,治疗组在常规治疗的基础上于发病后1周加用消瘀康胶囊.并于治疗前和治疗后第7、14天行头部CT检查,观察并计算血肿周围水肿变化及临床疗效.结果 治疗后第7、14天治疗组血肿及周围水肿体积明显低于对照组,神经功能缺损评分治疗组显著优于对照组.结论 消瘀康胶囊可有效减轻血肿周围水肿,改善高血压性脑出血继发性脑损伤,促进血肿吸收及神经功能康复.     

超声引导经阴道穿刺治疗输卵管积水

目的探讨超声引导经阴道穿刺治疗输卵管积水的临床效果。方法对61例输卵管积水患者行超声引导经阴道穿刺抽液及无水乙醇凝固治疗,随访3～12个月。结果61例患者中58例成功完成了液体抽吸及无水乙醇凝固治疗。术后3个月随访53例,其中治愈47例（88．7％）,好转2例（3．8％）,无效4例（7．5％）,总有效率为92．5％。术后12个月随访41例,其中治愈36例（87．8％）,好转2例（4．9％）,无效3例（7．3％）,总有效率为92．7％。所有囊内液细胞学检测均未发现癌细胞。结论超声引导经阴道穿刺治疗输卵管积水技术操作简单、疗效可靠。     

A novel application of amniotic membrane in patients with bullous keratopathy

To evaluate the efficacy of amniotic membrane in the management of painful bullous keratopathy secondary to the intractable glaucoma and in preventing exposure of drainage devices, we inserted Ahmed valve with amniotic membrane patch graft over the implant itself, and debrided corneal epithelium with amniotic membrane graft over the exposed stroma as a single operation. During the follow-up periods, we monitored vision, intraocular pressure (IOP), presence of ocular pain, and postoperative complications associated with the implants. The mean follow up period was 8.4+/-3.2 months. IOP was well controlled after the intervention. The preoperative mean IOP was measured as 43.9+/-9.0 mmHg and lowered to 16.1+/-1.8 mmHg at the last visit and no complications associated with the implants were noted. Even though the improvement in vision was not prominent, the ocular surface stabilized rapidly and ocular pain associated with bullous keratopathy disappeared soon after surgery. Conclusively the use of amniotic membrane in conjunction with Ahmed valve implantation is an effective way to relieve ocular pain and lessen the chances of complications associated with the implant in patients with intractable glaucoma and bullous keratopathy.     

Nicotinamide reduces acute cortical neuronal death and edema in the traumatically injured brain

Previous studies have shown that administration of nicotinamide (Vitamin B(3)) in animal models of traumatic brain injury (TBI) and ischemia significantly reduced the size of infarction or injury and improved functional recovery. The present study evaluated the ability of nicotinamide to provide acute neuroprotection and edema reduction following TBI. Groups of rats were assigned to nicotinamide (500mg/kg) or saline (1.0ml/kg) treatment conditions and received contusion injuries or sham surgeries. Drug treatment was administered 15min following injury. Brains were harvested 24h later and either processed for histology or water content. Frozen sections were stained with the degenerating neuron stain (Fluoro-Jade B) (FJ) and cell counts were performed at the site of injury. Additional brains were processed for water content (a measure of injury-induced edema). Results of this study showed that administration of nicotinamide following TBI significantly reduced the number of FJ(+) neurons in the injured cortex compared to saline-treated animals. Examination of the water content of the brains also revealed that administration of nicotinamide significantly attenuated the amount of water compared to saline-treated animals in the injured cortex. These results indicate that nicotinamide administration significantly reduced neuronal death and attenuated cerebral edema following injury. The current findings suggest that nicotinamide significantly modulates acute pathophysiological processes following injury and that this may account for its beneficial effects on recovery of function following injury.     

Matrix metalloproteinase-9 (MMP-9) in allergic nasal polyps

Matrix metalloproteinases (MMPs) are known to play important roles in the invasion of nasal mucosa by inflammatory cells through degradation of extracellular matrix. Matrix metalloproteinase-9 (MMP-9) is considered to play a role in the pathogenesis of nasal polyp. The aim of the present study was to compare plasma MMP-9 levels of patients with nasal polyp of different etiologic origins, those with allergic nasal polyp (ANP) and non-allergic nasal polyp (NANP). In all, 29 patients (20 NANP and 9 ANP) and 20 healthy subjects were included in this study. Plasma MMP-9 levels were measured using ELISA. Plasma MMP-9 levels were higher (p<0.05) in ANP patients than in NANP patients and controls. In the group with ANP, plasma MMP-9 levels showed a positive correlation (p<0.05) with eosinophil counts. Plasma MMP-9 levels of NANP patients and control groups were similar (p>0.05). Moreover, that the highest levels of MMP-9 were in ANP patients may indicate the usefulness of this parameter in differentiating between the different etiologic origins of nasal polyp. Further studies are required to elaborate on the relationship between MMP-9 levels and allergic reactions.     

Inhibition of central angiotensin-converting enzyme with enalapril protects the brain from ischemia/reperfusion injury in normotensive rat

Background and the Purpose of the study

Central Angiotensin Converting Enzyme (ACE) has an important role on cerebral microcirculation and metabolism. However, its role in terms of protecting the brain from ischemic/reperfusion (I/R) injury are debatable. This study evaluated the role of ACE, using enalapril as ACE inhibitor, in protection of the brain from I/R injury during transient focal cerebral ischemia (TFCI) in normotensive rat.

Method

Male Sprague Dawley rats (280–320g) randomly assigned to control ischemic and enalapril pre-treated ischemic groups. Enalapril was injected intraperitoneally 1 h before middle cerebral artery occlusion (MCAO) at the dose of 0.03 or 0.1 mg/kg. Cerebral ischemia was induced by 60 min MCAO followed by 24 hrs reperfusion. After evaluation of neurological deficit scores (NDS) the animal was sacrificed for assessment of cerebral infarction and edema.

Results

TFCI induced cerebral infarctions (283±18 mm³), brain edema (4.1±0.4%) and swelling (9.8±1.5%) with NDS of 3.11±0.36. Non-hypotensive dose of enalapril (0.03 mg/kg) improved NDS (1.37±0.26), reduced cerebral infarction (45%), brain edema (54%) and swelling of the lesioned hemispheres (34%) significantly. However, hypotensive dose of enalapril (0.1 mg/kg) could improve neurological activity (1.67±0.31) and failed to reduce cerebral infarction (276±39 mm³) and swelling (10.4±1.4%).

Conclusion

In the rat model of transient focal cerebral ischemia, inhibition of angiotensin converting enzyme with non-hypotensive doses of enalapril has the benefit of improving neurological activity, reducing cerebral infarction, brain swelling and edema of acute ischemic stroke. Therefore, it is reasonable to conclude that central renin-angiotensin system may participate in ischemic/reperfusion injury of the cerebral cortex.     

从瘀论治肾性水肿

肾性水肿是肾内科疾病的主要体征之一,中医将肾性水肿归属于"水气病"范畴,本文从血瘀角度论治肾性水肿。从瘀论治分气虚血瘀、气滞血瘀、阳虚寒凝血瘀、痰凝血瘀等。治疗上应多法联用,综合调治,辨证施治,因人而异。