Echinococcosis or hydatid disease (HD) is a zoonosis caused by the larval stages of taeniid cestodes belong- ing to the genus Echinococcus. Hepatic echinococcosis is a life-threatening disease, mainly differentiated...Echinococcosis or hydatid disease (HD) is a zoonosis caused by the larval stages of taeniid cestodes belong- ing to the genus Echinococcus. Hepatic echinococcosis is a life-threatening disease, mainly differentiated into alveolar and cystic forms, associated with Echinoc- cus multilocularis (E. multi/ocular/s) and Echinococcus granulosus (E. granulosus) infection, respectively. Cys- tic echinococcosis (CE) has a worldwide distribution, while hepatic alveolar echinococcosis (AE) is endemic in the Northern hemisphere, including North America and several Asian and European countries, like France, Germany and Austria. E. granulosus young cysts are spherical, unilocular vesicles, consisting of an internal germinal layer and an outer acellular layer. Cyst expansion is associated with a host immune reaction and the subsequent development of a fibrous layer, called the per/cyst; old cysts typically present internal septa- tions and daughter cysts. E. multilocularis has a tumor-like, infiltrative behavior, which is responsible for tissue destruction and finally for liver failure. The liver is the main site of HD involvement, for both alveolar and cystic hydatidosis. HD is usually asymptomatic for a long period of time, because cyst growth is commonly slow; the most frequent symptoms are fatigue and abdominal pain. Patients may also present jaundice, hepatomegaly or anaphylaxis, due to cyst leakage or rupture. HD diagnosis is usually accomplished with the combined use of ultrasonography and immunodiagnosis; furthermore, the improvement of surgical techniques, the introduction of minimally invasive treatments [such as puncture, aspiration, injection, re-aspiration (PAIR)] and more effective drugs (such as benzoimidazoles) have deeply changed life expectancy and quality of life of patients with HD. The aim of this article is to provide an up-to-date review of biological, diagnostic, clinical and therapeutic aspects of hepatic echinococcosis.展开更多
Hepatic encephalopathy (HE) is a common neuropsychiatric abnormality, which complicates the course of patients with liver disease and results from hepatocellular failure and/or portosystemic shunting. The manifestat...Hepatic encephalopathy (HE) is a common neuropsychiatric abnormality, which complicates the course of patients with liver disease and results from hepatocellular failure and/or portosystemic shunting. The manifestations of HE are widely variable and involve a spectrum from mild subclinical disturbance to deep coma. Research interest has focused on the role of circulating gut-derived toxins, particularly ammonia, the development of brain swelling and changes in cerebral neurotransmitter systems that lead to global CNS depression and disordered function. Until recently the direct investigation of cerebral function has been difficult in man. However, new magnetic resonance imaging (MRI) techniques provide a non-invasive means of assessment of changes in brain volume (coregistered MRI) and impaired brain function (fMRI), while proton magnetic resonance spectroscopy (^1H MRS) detects changes in brain biochemistry, including direct measurement of cerebral osmolytes, such as myoinositol, glutamate and glutamine which govern processes intrinsic to cellular homeostasis, including the accumulation of intracellular water. The concentrations of these intracellular osmolytes alter with hyperammonaemia. MRS-detected metabolite abnormalities correlate with the severity of neuropsychiatric impairment and since MR spectra return towards normal after treatment, the technique may be of use in objective patient monitoring and in assessing the effectiveness of various treatment regimens.展开更多
Nuclear magnetic resonance spectroscopy allows the study of cellular biochemistry and metabolism, both in the whole body in vivo and at higher magnetic field strengths in vitro. Since the technique is non-invasive and...Nuclear magnetic resonance spectroscopy allows the study of cellular biochemistry and metabolism, both in the whole body in vivo and at higher magnetic field strengths in vitro. Since the technique is non-invasive and non-selective, magnetic resonance spectroscopy methodologies have been widely applied in biochemistry and medicine. In vitro magnetic resonance spectroscopy studies of cells, body fluids and tissues have been used in medical biochemistry to investigate pathophysiologi- cal processes and more recently, the technique has been used by physicians to determine disease abnormalities in vivo. This highlighted topic illustrates the potential of in vitro magnetic resonance spectroscopy in studying the hepatobiliary system. The role of in vitro proton and phosphorus magnetic resonance spectroscopy in the study of malignant and non-malignant liver disease and bile composition studies are discussed, particularly with reference to correlative in vivo whole-body magnetic resonance spectroscopy applications. In summary, magnetic resonance spectroscopy techniques can provide non-invasive biochemical information on disease severity and pointers to underlying pathophysiological processes. Magnetic resonance spectroscopy holds potential promise as a screening tool for disease biomarkers, as well as assessing therapeutic response.展开更多
AIM: To investigate the serum positive percentage of TT virus (TTV) in patients with chronic hepatitis B or C and the response of the coinfected TTV to interferon (IFN) during IFN therapy for chronic hepatitis B and C...AIM: To investigate the serum positive percentage of TT virus (TTV) in patients with chronic hepatitis B or C and the response of the coinfected TTV to interferon (IFN) during IFN therapy for chronic hepatitis B and C. METHODS: We retrospectively studied the serum samples of 70 patients with chronic hepatitis who had received IFN-alpha therapy from January 1997 to June 2000, which included 40 cases of hepatitis B and 30 hepatitis C. All the patients had been followed up for at least 6 months after the end of IFN therapy. The serum TTV DNA was detected using the polymerase chain reaction (PCR) before and every month during the course of IFN treatment. RESULTS: TTV infection was detected in 15% (6/40) of the chronic hepatitis B group and 30% (9/30) of the chronic hepatitis C group. Loss of serum TTV DNA during IFN therapy occurred in 3 of 6 patients (50%) and 6 of 9 (67%) of hepatitis B and C groups, respectively. Seronegativity of TTV was found all during the first month of IFN therapy in the 9 patients. There was no correlation between the seroconversion of TTV and the biochemical changes of the patients. CONCLUSION: TTV is not infrequently coinfected in patients with chronic hepatitis B and C in Taiwan, and more than half of the TTV infections are IFN-sensitive. However, the loss of serum TTV DNA does not affect the clinical course of the patients with chronic hepatitis B or C.展开更多
Treating common benign anal diseases has evolved towards more outpatient procedures with better outcome. However, minimizing post-procedure morbidities such as pain and the avoidance incontinence remain the most signi...Treating common benign anal diseases has evolved towards more outpatient procedures with better outcome. However, minimizing post-procedure morbidities such as pain and the avoidance incontinence remain the most significant concerns. We introduce some controversies and highlight the developments in current surgical practice for the treatment of common anal problems.展开更多
Objective Cystic meningiomas are quite rare. There is a great controversy concerning the management of the cystic wall. We reported six peritumoral cystic meningiomas and reviewed the literature to discuss the managem...Objective Cystic meningiomas are quite rare. There is a great controversy concerning the management of the cystic wall. We reported six peritumoral cystic meningiomas and reviewed the literature to discuss the management of the cystic wall. Methods Six cases of peritumoral cystic meningiomas were retrospectively analyzed. Results Gadolinium-enhanced Tl-weighted magnetic resonance imaging scans disclosed the solid tumor enhancement in 3 cases, the cystic wall enhancement in 2 cases. One case only showed the cystic lesion. All the tumors were totally removed ( including the involved dura and partial cystic wall). Histopathological examination showed 3 meningiotheliomatous meningiomas, 2 microcystic meningiomas, 1 mucoid degeneration. After operation, all the patients recovered well and demonstrated no neurological deficit. During the follow-up time, no tumor was recurrence. Conclusion Magnetic resonance imaging with contrast enhancement can provide information regarding whether surgical removal of the cystic wall is indicated. Peripheral enhancement of the cystic wall strongly indicates the presence of tumor infiltration. The removal of the entire cystic wall should be performed, excessive damage to brain be prevented.展开更多
Since Lenger's detection of magnetic photons in homeopathic remedies by magnetic resonance the mystery of homeopathy comes to a solution. Homeopathy is a regulation therapy curing hypo- and hyper-functions of patholo...Since Lenger's detection of magnetic photons in homeopathic remedies by magnetic resonance the mystery of homeopathy comes to a solution. Homeopathy is a regulation therapy curing hypo- and hyper-functions of pathological pathways. It reacts according to the principle of resonance. The fundamental principles of homeopathy as proving, symptom picture, curing according to the Law of Similars and the production of homeopathic remedies over the Avogadro number by repeated dilution and succussion are explained to have the same frequencies so that the resonance principle can work. Pathological pathways are cured by using their highly potentized substrates, inhibitors and enzymes, given daily or each second day. This is in contradiction to the normal applied homeopathy. The efficacy of homeopathy now has a scientific base and is completely explained by applying biochemical and biophysical laws.展开更多
Heart failure is a major public health problem worldwide. Despite advances in the therapy and care of heart failure, morbidity and mortality remain persistently high. Recent years have witnessed major breakthroughs in...Heart failure is a major public health problem worldwide. Despite advances in the therapy and care of heart failure, morbidity and mortality remain persistently high. Recent years have witnessed major breakthroughs in the investigations of pathogenesis, prevention, and treatment of heart failure in China. It is noteworthy that the continuing and growing support from funding agencies in China including the National Natural Science Foundation of China has yielded substantial effects on the basic and clinical research in heart failure in the last decade. In this review, we provide an update on the current status of heart failure research, both basic and translational/clinical, in China, including funding and publications. We also discuss the future challenges and possible strategies in improving our understanding and management of heart failure in China.展开更多
The emerging resistance to schistosoma has been paid much attention and is in urgent need for a novel strategy to control the prevalent parasitic zoonosis. In this study, the efficiency of hyperthermia therapy was inv...The emerging resistance to schistosoma has been paid much attention and is in urgent need for a novel strategy to control the prevalent parasitic zoonosis. In this study, the efficiency of hyperthermia therapy was investigated by the skin hyperthermia device. The survival rate of cercariae decreased from 68.15 % (37 ℃, 5 min) to 0 (49℃, 10 min) with the thermal dosages increased, which proved the preventing effect of hyperthermia therapy (P 〈 0.05). Therapeutic effects were assessed in Schistosoma japonicum-infected BALB/c mice. When the cercarial contact region of the skin was treated at 45-49℃ for 5 min within 8 h of infection, worm reduction rate (WRR) reached 74 %-83 % (P 〈 0.01). The sensitivity of adult schistosoma to heat was also investigated using microwave intraperitoneal hyperthermia (thermal dosages 42-43℃, 20 min). The WRR, hepatic shift rates and egg reduction rates were 23.7 %, 40 % and 30 %, respectively, comparing with 80.2 %, 59.6 % and 53.9 % of praziquantel (PZQ)-treated group. Encouraging results have been obtained that hyperthermia can effectively kill schistosomula, especially with the appearance of cercarial dermatitis, while PZQ lacks efficacy against the cercariae. Thus, hyperthermia therapy would show significant benefit in preventing and treatment of schistosoma, especially in the early stage.展开更多
We reported a 30 years old man who suffered a bite wound of the right hand in a fight. Two days after the injury, he was admitted in emergency because of stab wound above the head of the third metacarpal bone. He pres...We reported a 30 years old man who suffered a bite wound of the right hand in a fight. Two days after the injury, he was admitted in emergency because of stab wound above the head of the third metacarpal bone. He presented the swelling, redness, pain and fever. Primary revision confirmed only partial lesion of the extensor apparatus. During the following days, we recorded a deterioration of local findings and magnetic resonance imaging revealed osteomyelitis and septic arthritis of the third metacarpophalangeal joint. The wound was then revised several times using negative pressure wound therapy in combination with intravenous antibiotics. After resolution of clinical and laboratory findings, the wound was finally closed by delayed primary suture. Clenched fist injury is a medical emergency that requires immediate surgical revision. We treated clenched fist injury with the development of septic arthritis and osteo- myelitis with negative pressure wound therapy and obtained good outcomes.展开更多
文摘Echinococcosis or hydatid disease (HD) is a zoonosis caused by the larval stages of taeniid cestodes belong- ing to the genus Echinococcus. Hepatic echinococcosis is a life-threatening disease, mainly differentiated into alveolar and cystic forms, associated with Echinoc- cus multilocularis (E. multi/ocular/s) and Echinococcus granulosus (E. granulosus) infection, respectively. Cys- tic echinococcosis (CE) has a worldwide distribution, while hepatic alveolar echinococcosis (AE) is endemic in the Northern hemisphere, including North America and several Asian and European countries, like France, Germany and Austria. E. granulosus young cysts are spherical, unilocular vesicles, consisting of an internal germinal layer and an outer acellular layer. Cyst expansion is associated with a host immune reaction and the subsequent development of a fibrous layer, called the per/cyst; old cysts typically present internal septa- tions and daughter cysts. E. multilocularis has a tumor-like, infiltrative behavior, which is responsible for tissue destruction and finally for liver failure. The liver is the main site of HD involvement, for both alveolar and cystic hydatidosis. HD is usually asymptomatic for a long period of time, because cyst growth is commonly slow; the most frequent symptoms are fatigue and abdominal pain. Patients may also present jaundice, hepatomegaly or anaphylaxis, due to cyst leakage or rupture. HD diagnosis is usually accomplished with the combined use of ultrasonography and immunodiagnosis; furthermore, the improvement of surgical techniques, the introduction of minimally invasive treatments [such as puncture, aspiration, injection, re-aspiration (PAIR)] and more effective drugs (such as benzoimidazoles) have deeply changed life expectancy and quality of life of patients with HD. The aim of this article is to provide an up-to-date review of biological, diagnostic, clinical and therapeutic aspects of hepatic echinococcosis.
基金Supported by grants from BUPA, the Royal College of Physicians of London and Paddington Charitable Trust, St Mary's,London. The European Association for the Study of the Liver, the British Medical Research Council (G9900178)Philips Medical Systems (Cleveland, Ohio, USA) and the United Kingdom Department of Health provided support for some of the studies outlined
文摘Hepatic encephalopathy (HE) is a common neuropsychiatric abnormality, which complicates the course of patients with liver disease and results from hepatocellular failure and/or portosystemic shunting. The manifestations of HE are widely variable and involve a spectrum from mild subclinical disturbance to deep coma. Research interest has focused on the role of circulating gut-derived toxins, particularly ammonia, the development of brain swelling and changes in cerebral neurotransmitter systems that lead to global CNS depression and disordered function. Until recently the direct investigation of cerebral function has been difficult in man. However, new magnetic resonance imaging (MRI) techniques provide a non-invasive means of assessment of changes in brain volume (coregistered MRI) and impaired brain function (fMRI), while proton magnetic resonance spectroscopy (^1H MRS) detects changes in brain biochemistry, including direct measurement of cerebral osmolytes, such as myoinositol, glutamate and glutamine which govern processes intrinsic to cellular homeostasis, including the accumulation of intracellular water. The concentrations of these intracellular osmolytes alter with hyperammonaemia. MRS-detected metabolite abnormalities correlate with the severity of neuropsychiatric impairment and since MR spectra return towards normal after treatment, the technique may be of use in objective patient monitoring and in assessing the effectiveness of various treatment regimens.
基金Supported by the Hammersmith Hospital Trustees Research Committee, the Medical Research Council, JEOL (UK) Ltd., Phil- ips Medical Systems and the Higher Education Funding Council for England
文摘Nuclear magnetic resonance spectroscopy allows the study of cellular biochemistry and metabolism, both in the whole body in vivo and at higher magnetic field strengths in vitro. Since the technique is non-invasive and non-selective, magnetic resonance spectroscopy methodologies have been widely applied in biochemistry and medicine. In vitro magnetic resonance spectroscopy studies of cells, body fluids and tissues have been used in medical biochemistry to investigate pathophysiologi- cal processes and more recently, the technique has been used by physicians to determine disease abnormalities in vivo. This highlighted topic illustrates the potential of in vitro magnetic resonance spectroscopy in studying the hepatobiliary system. The role of in vitro proton and phosphorus magnetic resonance spectroscopy in the study of malignant and non-malignant liver disease and bile composition studies are discussed, particularly with reference to correlative in vivo whole-body magnetic resonance spectroscopy applications. In summary, magnetic resonance spectroscopy techniques can provide non-invasive biochemical information on disease severity and pointers to underlying pathophysiological processes. Magnetic resonance spectroscopy holds potential promise as a screening tool for disease biomarkers, as well as assessing therapeutic response.
文摘AIM: To investigate the serum positive percentage of TT virus (TTV) in patients with chronic hepatitis B or C and the response of the coinfected TTV to interferon (IFN) during IFN therapy for chronic hepatitis B and C. METHODS: We retrospectively studied the serum samples of 70 patients with chronic hepatitis who had received IFN-alpha therapy from January 1997 to June 2000, which included 40 cases of hepatitis B and 30 hepatitis C. All the patients had been followed up for at least 6 months after the end of IFN therapy. The serum TTV DNA was detected using the polymerase chain reaction (PCR) before and every month during the course of IFN treatment. RESULTS: TTV infection was detected in 15% (6/40) of the chronic hepatitis B group and 30% (9/30) of the chronic hepatitis C group. Loss of serum TTV DNA during IFN therapy occurred in 3 of 6 patients (50%) and 6 of 9 (67%) of hepatitis B and C groups, respectively. Seronegativity of TTV was found all during the first month of IFN therapy in the 9 patients. There was no correlation between the seroconversion of TTV and the biochemical changes of the patients. CONCLUSION: TTV is not infrequently coinfected in patients with chronic hepatitis B and C in Taiwan, and more than half of the TTV infections are IFN-sensitive. However, the loss of serum TTV DNA does not affect the clinical course of the patients with chronic hepatitis B or C.
文摘Treating common benign anal diseases has evolved towards more outpatient procedures with better outcome. However, minimizing post-procedure morbidities such as pain and the avoidance incontinence remain the most significant concerns. We introduce some controversies and highlight the developments in current surgical practice for the treatment of common anal problems.
文摘Objective Cystic meningiomas are quite rare. There is a great controversy concerning the management of the cystic wall. We reported six peritumoral cystic meningiomas and reviewed the literature to discuss the management of the cystic wall. Methods Six cases of peritumoral cystic meningiomas were retrospectively analyzed. Results Gadolinium-enhanced Tl-weighted magnetic resonance imaging scans disclosed the solid tumor enhancement in 3 cases, the cystic wall enhancement in 2 cases. One case only showed the cystic lesion. All the tumors were totally removed ( including the involved dura and partial cystic wall). Histopathological examination showed 3 meningiotheliomatous meningiomas, 2 microcystic meningiomas, 1 mucoid degeneration. After operation, all the patients recovered well and demonstrated no neurological deficit. During the follow-up time, no tumor was recurrence. Conclusion Magnetic resonance imaging with contrast enhancement can provide information regarding whether surgical removal of the cystic wall is indicated. Peripheral enhancement of the cystic wall strongly indicates the presence of tumor infiltration. The removal of the entire cystic wall should be performed, excessive damage to brain be prevented.
文摘Since Lenger's detection of magnetic photons in homeopathic remedies by magnetic resonance the mystery of homeopathy comes to a solution. Homeopathy is a regulation therapy curing hypo- and hyper-functions of pathological pathways. It reacts according to the principle of resonance. The fundamental principles of homeopathy as proving, symptom picture, curing according to the Law of Similars and the production of homeopathic remedies over the Avogadro number by repeated dilution and succussion are explained to have the same frequencies so that the resonance principle can work. Pathological pathways are cured by using their highly potentized substrates, inhibitors and enzymes, given daily or each second day. This is in contradiction to the normal applied homeopathy. The efficacy of homeopathy now has a scientific base and is completely explained by applying biochemical and biophysical laws.
文摘Heart failure is a major public health problem worldwide. Despite advances in the therapy and care of heart failure, morbidity and mortality remain persistently high. Recent years have witnessed major breakthroughs in the investigations of pathogenesis, prevention, and treatment of heart failure in China. It is noteworthy that the continuing and growing support from funding agencies in China including the National Natural Science Foundation of China has yielded substantial effects on the basic and clinical research in heart failure in the last decade. In this review, we provide an update on the current status of heart failure research, both basic and translational/clinical, in China, including funding and publications. We also discuss the future challenges and possible strategies in improving our understanding and management of heart failure in China.
基金supported by the Bill & Melinda Gates Foundation(Grant No.1024516)
文摘The emerging resistance to schistosoma has been paid much attention and is in urgent need for a novel strategy to control the prevalent parasitic zoonosis. In this study, the efficiency of hyperthermia therapy was investigated by the skin hyperthermia device. The survival rate of cercariae decreased from 68.15 % (37 ℃, 5 min) to 0 (49℃, 10 min) with the thermal dosages increased, which proved the preventing effect of hyperthermia therapy (P 〈 0.05). Therapeutic effects were assessed in Schistosoma japonicum-infected BALB/c mice. When the cercarial contact region of the skin was treated at 45-49℃ for 5 min within 8 h of infection, worm reduction rate (WRR) reached 74 %-83 % (P 〈 0.01). The sensitivity of adult schistosoma to heat was also investigated using microwave intraperitoneal hyperthermia (thermal dosages 42-43℃, 20 min). The WRR, hepatic shift rates and egg reduction rates were 23.7 %, 40 % and 30 %, respectively, comparing with 80.2 %, 59.6 % and 53.9 % of praziquantel (PZQ)-treated group. Encouraging results have been obtained that hyperthermia can effectively kill schistosomula, especially with the appearance of cercarial dermatitis, while PZQ lacks efficacy against the cercariae. Thus, hyperthermia therapy would show significant benefit in preventing and treatment of schistosoma, especially in the early stage.
文摘We reported a 30 years old man who suffered a bite wound of the right hand in a fight. Two days after the injury, he was admitted in emergency because of stab wound above the head of the third metacarpal bone. He presented the swelling, redness, pain and fever. Primary revision confirmed only partial lesion of the extensor apparatus. During the following days, we recorded a deterioration of local findings and magnetic resonance imaging revealed osteomyelitis and septic arthritis of the third metacarpophalangeal joint. The wound was then revised several times using negative pressure wound therapy in combination with intravenous antibiotics. After resolution of clinical and laboratory findings, the wound was finally closed by delayed primary suture. Clenched fist injury is a medical emergency that requires immediate surgical revision. We treated clenched fist injury with the development of septic arthritis and osteo- myelitis with negative pressure wound therapy and obtained good outcomes.