粥道

常去一家粥店吃粥。粥店的老板在粥锅旁放了一张长长的桌子，桌子上搁着几排碗，每个碗里装着半碗粥。常常过来吃饭的顾客习惯自己动手，端上一个碗，。自己从锅里再舀半碗粥添上，就是一碗了。

Berberine promotes the development of atherosclerosis and foam cell formation by inducing scavenger receptor A expression in macrophage

Berberine is identified to lower the serum cholesterol level in human and hamster through the induction of low density lipoproteins （LDL） receptor in hepatic cells. To evaluate its potential in preventing atherosclerosis, the effect of berberine on atherosclerosis development in apolipoprotcin E-deficient （apoE^-/-） mice was investigated. In apoE^-/- mice, berberine induced in rivo foam cell formation and promoted atheroselerosis development. The foam cell formation induced by berberinc was also observed in mouse RAW264.7 cells, as well as in mouse and human primary macrophages. By inducing scavenger receptor A （SR-A） expression in macrophages, berberine increased the uptake of modified LDL （DiO-Ac-LDL）. Bcrberine-induced SR-A expression was also observed in macrophage foam cells in vivo and in the cells at atherosclerotic lesion. Analysis in RAW264.7 cells indicated that berberine induced SR-A expression by suppressing PTEN expression, which led to sustained Akt activation. Our results suggest that to evaluate the potential of a cholesterol-reducing compound in alleviating atherosclerosis, its effect on the ceils involved in atherosclerosis development, such as macrophages, should also be considered. Promotion of foam cell formation could counter-balance the beneficial effect of lowering serum cholesterol.

Enigma of primary aortoduodenal fistula

A diagnosis of primary aortoenteric fistula is difficult to make despite a high level of clinical suspicion. It should be considered in any elderly patient who presents with upper gastrointestinal bleeding in the context of a known abdominal aortic aneurysm. We present the case of young man with no history of abdominal aortic aneurysm who presented with massive upper gastrointestinal bleeding. Initial misdiagnosis led to a delay in treatment and the patient succumbing to the illness. This case is unique in that the fistula formed as a result of complex atherosclerotic disease of the abdominal aorta, and not from an aneurysm.

Application of transesophageal echocardiography to aortic embolic stroke

OBJECTIVES: To determine the relative value of transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE) in exploring the potential embolic source (PES) in heart and aortic arch and to study the clinical significance of aortic arch atherosclerosis (AAA). METHODS: Forty-nine patients with cerebral embolism were included in this study. TEE and TTE were used to evaluate the potential source of emboli in aortic arch, heart and duplex in the carotid artery. An atherosclerotic lesion of the aortic arch was defined as normal, mild plaque, moderate plaque, and protruding plaque or mobile plaque. RESULTS: Of the 49 patients, 31 (63%) patients showed evidence of AAA: 7 (14.1%) patients were mild, 9 (18.4%) were moderate and 15 (30.6%) were severe. In those 15 patients, 11 had neither severe ICAA nor heart disease. Thirty-three patients had internal carotid arterial atherosclerosis (ICAA). The potential sources of embolization of heart and aortic arch is 48.98% by TEE, but only 18.4% by TTE; 9 patients had heart disease. Age and ICAA were significantly correlated with AAA. CONCLUSION: At present, TEE is a better method for exploring atherosclerotic lesions in the thoracic aorta. AAA is an important potential source of cerebral embolic stroke.

Application of transesophageal echocardiography to aortic embolic stroke

s To determine the relative value of transesophageal echocardiography (TEE) and tr ansthoracic echocardiography (TTE) in exploring the potential embolic source (PE S) in heart and aortic arch and to study the clinical significance of aortic arc h athersclerosis (AAA) Methods Forty nine patients with cerebral embolism were included in this study TEE an d TTE were used to evaluate the potential source of emboli in aortic arch, heart and duplex in the carotid artery An atherosclerotic lesion of the aortic arch was defined as normal, mild plaque, moderate plaque, and protruding plaque or m obile plaque Results Of the 49 patients, 31(63%) patients showed evidence of AAA: 7 (14 1%) patients were mild, 9 (18 4%) were moderate and 15 (30 6%) were severe In those 15 p atients, 11 had neither severe ICAA nor heart disease Thirty three patients h ad internal carotid arterial atherosclerosis (ICAA) The potential sources of e mbolization of heart and aortic arch is 48 98% by TEE, but only 18 4% by TTE; 9 patients had heart disease Age and ICAA were significantly correlated with A AA Conclusion At present, TEE is a better method for exploring atherosclerotic lesions in the thoracic aorta AAA is an important potential source of cerebral embolic stroke

Gastroduodenal artery aneurysm - A rare complication of traumatic pancreatic injury

Aneurysm of gastroduodenal artery （CDA） is rare. Most reported cases are due to pancreatitis and atherosclerosis; however, those following pancreatic trauma have not been reported. We encountered GDA aneurysm in a patient of blunt abdominal trauma, who had pancreatic contusion and retroduodenal air on contrast enhanced computed tomography of abdomen. Emergency laparotomy for suspected duodenal injury revealed duodenal wall and pancreatic head contusion, mild hemoperitoneum and no evidence of duodenal perforation. In the postoperative period, the patient developed upper gastrointestinal hemorrhage on day 5. Repeat imaging revealed GDA aneurysm, which was managed successfully by angioembolization. This case highlights, one, delayed presen- tation of GDA aneurysm after blunt pancreatic trauma and two, its successful management using endovascular technique.