Diabetes mellitus and associated chronic hyperglycemia enhance the risk of acute ischemic stroke and lead to worsened clinical outcome and increased mortality. However, post-stroke hyperglycemia is also present in a n...Diabetes mellitus and associated chronic hyperglycemia enhance the risk of acute ischemic stroke and lead to worsened clinical outcome and increased mortality. However, post-stroke hyperglycemia is also present in a number of non-diabetic patients after acute ischemic stroke, presumably as a stress response. The aim of this review is to summarize the main effects of hyperglycemia when associated to ischemic injury in acute stroke patients, highlighting the clinical and neurological outcomes in these conditions and after the administration of the currently approved pharmacological treatment, i.e. insulin. The disappointing results of the clinical trials on insulin(including the hypoglycemic events) demand a change of strategy based on more focused therapies. Starting from the comprehensive evaluation of the physiopathological alterations occurring in the ischemic brain during hyperglycemic conditions, the effects of various classes of glucose-lowering drugs are reviewed, such as glucose-like peptide-1 receptor agonists, DPP-4 inhibitors and sodium glucose cotransporter 2 inhibitors, in the perspective of overcoming the up-to-date limitations and of evaluating the effectiveness of new potential therapeutic strategies.展开更多
Osteoarthritis and psoriasis arthritis are two degenerative forms of arthritis that share similar yet also different manifestations at the histological,cellular,and clinical levels.Rheumatologists have marked them as ...Osteoarthritis and psoriasis arthritis are two degenerative forms of arthritis that share similar yet also different manifestations at the histological,cellular,and clinical levels.Rheumatologists have marked them as two entirely distinct arthropathies.Given recent dis-coveries in disease initiation and progression,potential mechanisms,cellular signaling path-ways,and ongoing clinical therapeutics,there are now more opportunities for discovering osteoarthritis drugs.This review summarized the osteoarthritis and psoriasis arthritis signaling pathways,crosstalk between BMP,WNT,TGF-β,VEGF,TLR,and FGF signaling pathways,bio-markers,and anatomical pathologies.Through bench research,we demonstrated that regen-erative medicine is a promising alternative for treating osteoarthritis by highlighting significant scientific discoveries on entheses,multiple signaling blockers,and novel molecules such as immunoglobulin new antigen receptors targeted for potential drug evaluation.Furthermore,we offered valuable therapeutic approaches with a multidisciplinary strategy to treat patients with osteoarthritis or psoriasis arthritis in the coming future in the clinic.展开更多
发育性髋关节发育不良(developmental dysplasia of the hip,DDH)是常见的儿童肢体畸形,早期筛查和诊断非常重要,延误治疗或治疗不当将导致严重后果。股骨头缺血性坏死(avascular necrosis,AVN)是DDH闭合复位后严重且常见的并发症,如何...发育性髋关节发育不良(developmental dysplasia of the hip,DDH)是常见的儿童肢体畸形,早期筛查和诊断非常重要,延误治疗或治疗不当将导致严重后果。股骨头缺血性坏死(avascular necrosis,AVN)是DDH闭合复位后严重且常见的并发症,如何预防及避免AVN的发生一直困扰着小儿骨科医师。闭合复位前骨化核的存在似乎有助于降低AVN发生率,避免AVN的发生与DDH早诊断、早治疗关系密切。本文就骨化核与DDH闭合复位后AVN相关性的研究进展进行综述。展开更多
Bland-White-Garland syndrome or ALCAPA is an abnormality of birth of the left coronary artery from the pulmonary artery. It is a diagnostic and therapeutic emergency because it is a curable cause of hypokinetic dilate...Bland-White-Garland syndrome or ALCAPA is an abnormality of birth of the left coronary artery from the pulmonary artery. It is a diagnostic and therapeutic emergency because it is a curable cause of hypokinetic dilated heart disease in infants. We report through this clinical case, the fourth case of infantile ALCAPA diagnosed in Senegal in a 7-month-old infant. The symptomatology began around the age of 2 months, with a grumpy state associated with more marked crying and moaning during feedings and bowel movements. The mother reported hospitalization for a severe lung infection when she was 6 months old. The examination noted an infant in poor general condition, retarded growth and weight, and a 3/6th holosystolic murmur at the apex. Troponinemia was positive at 43.90 ng/L. The electrocardiogram showed Q waves on the lower side, a sub endocardial lesion on the upper side and a ST segment elevation in aVR. Doppler echocardiography showed dilated cardiomyopathy with a mean alteration of systolic function of the left ventricle at 37%, a mean mitral insufficiency and a strong suspicion of a birth anomaly of the left coronary artery. The CT scan confirmed the diagnosis of ALCAPA. Surgicalreimplantation of the left coronary artery at the aortic level was performed at 10 months of life with a favourable outcome at D50 postoperative.展开更多
INTRODUCTIONIt is axiomatic that the most effective and soundlybased plan of treatment of any disorder is one aimedat the mechanism or mechanisms responsible for itsdevelopment.This basic notion,coupled withrecent rep...INTRODUCTIONIt is axiomatic that the most effective and soundlybased plan of treatment of any disorder is one aimedat the mechanism or mechanisms responsible for itsdevelopment.This basic notion,coupled withrecent reports in which,surprisingly there is atotal lack of reference to the probable involvementof autonomic-arc-reflexes in the展开更多
AIM To investigate the secreting functions of saliva in patients with TCM Piyinxu (Spleen yin deficiency). METHODS According to the traditional Chinese medical diagnositic standard, 25 cases of Piyinxu (male 15, ...AIM To investigate the secreting functions of saliva in patients with TCM Piyinxu (Spleen yin deficiency). METHODS According to the traditional Chinese medical diagnositic standard, 25 cases of Piyinxu (male 15, female 10, aged from 26~70, average 45 years) were observed and compared with 20 cases of Shenyinxu (Kidney yin deficiency) patients (male 11, female 9, aged from 35~75, average 50) and 30 normal persons (male 17, female 13, aged from 35~65, average 49). After acid stimulation, the secretion flow was measured, the saliva amylase and protein were surveyed using the automatic biochemical analyzer. Statistical analysis was carried out with Kruskal Wallis test and one way factorial ANOVA test. RESULTS In Piyinxu patients, the saliva′s secreting flow rate (0 27ml/min±0 016ml/min) and amylase per min (2134 13IU/min±343 51IU/min) was lower than that in normal subjects (0 46ml/min±0 027ml/min and 3501 63IU/min±1099 63IU/min, P <0 01) and higher than that in Shenyinxu group (0 13ml/min±0 051ml/min and 951 62IU/min±383 17IU/min, P <0 01). But there was no significant difference between each group in total salivary protein (Piyinxu group 3 07g/L±0 60g/L, Shenyinxu 3 01g/L±0 90g/L and control 2 94g/L±1 13g/L, P =0 869), amylase per volume and the ratio of the amylase to the protein ( P =0 173 and 0 436). CONCLUSION The secreting functions of saliva in Piyinxu patients are low.展开更多
AIM To investigate the etiologic association of pancreas divisum (PD) with chronic pancreatitis and to clarify its pathogenesis. METHODS A PD canine model was established in 32 dogs. The dogs were randomly divided ...AIM To investigate the etiologic association of pancreas divisum (PD) with chronic pancreatitis and to clarify its pathogenesis. METHODS A PD canine model was established in 32 dogs. The dogs were randomly divided into 4 groups ( n =8). Group Ⅰ: The communicating branch between the dorsal and ventral pancreatic ducts was partly ligated. Group Ⅱa: The communicating branch was amputated and completely ligated. Group Ⅱb: The dorsal duct was amputated and ligated at 2mm distance to the minor papilla. Group Ⅲ: A sham operation without any amputation or ligation was performed. Before and after operation, the activities of serum phospholipase A2 (PLA2) and amylase (Ams) were assayed and the basal pressures of the ducts were measured when secretin was injected. Pancreatic ductography and the pathologic examination were made. RESULTS The activities of serum PLA2 and Ams in Group Ⅰ,Ⅱa and Ⅱb were significantly increased 5-80 days after operation. At sacrifice, the basal pressures of the ventral duct were significantly higher 30min-60min after provocation in Group Ⅰ, Ⅱa and Ⅱb. The pressures of the dorsal duct were significantly increased in Group Ⅱb but no difference in Group Ⅰ and Ⅱa. Under light microscopy the fibrosis of interlobus and periducts, the destruction of acini and infiltration of inflammatory cell in dorsal and ventral pancreas were found in Group Ⅱb. But in Group Ⅰ and Ⅱa, these findings were present only in ventral pancreas. The electron microscopy showed that in ventral pancreas of Groups Ⅰ and Ⅱa and the dorsal and ventral pancreas of Group Ⅱb, the rough endoplasmic reticulum of the acinar cells showed granules scaling, fusion and dilatation. The zymogen granules decreased and the mitochondria was swollen. CONCLUSION PD is one of etiologic factors in chronic pancreatitis. The pathogenesis is the functional obstruction of the minor papilla at the peak stage of secretion.展开更多
目的为深入研究酒精性肝病的发病机制,提供一个简单可行的动物模型,并利用此模型检测血浆PDGF含量在酒精性肝病发生发展中的变化。方法本研究在平衡饮食的条件下,以400mL·L^(-1)乙醇,8g·kg^(-1)·d^(-1),日3次灌胃至4wk末...目的为深入研究酒精性肝病的发病机制,提供一个简单可行的动物模型,并利用此模型检测血浆PDGF含量在酒精性肝病发生发展中的变化。方法本研究在平衡饮食的条件下,以400mL·L^(-1)乙醇,8g·kg^(-1)·d^(-1),日3次灌胃至4wk末,自5wk,以500 mL·L^(-1)乙醇,9g·kg^(-1)·d^(-1),日3次灌胃至8 wk末,自9 wk,以500mL·L^(-1)乙醇,10g·kg^(-1)·d^(-1)日3次灌胃至12wk末,诱导酒精性肝病大鼠动物模型,分别于4wk末、8wk末、12wk末观察肝脏病理学改变,并用生物活性法测定了对照组及实验组不同病理阶段血浆中血小板源性生长因子(PDGF)的含量。结果光镜显示对照组肝细胞以中央静脉为中心呈放射状排列,酒精摄入4wk末,肝细胞中重度脂肪变性,8wk末肝细胞变性坏死,炎性细胞浸润,Mallory染色可见胶原于中央静脉沉积增加,12wk末变性坏死及炎性细胞浸润明显,Mallory染色可见胶原自中央静脉向窦周隙伸展,呈现轻度肝纤维化改变,PDGF含量结果可见与同时期对照组相比,实验组PDGF含量(kU·L^(-1))均有显著增高,4,8,12wk分别为67±15 vs 31±18(P<0.05),130±30vs33±19(P<0.001),202±20 vs 36±6(P<0.001);实验组不同时期差异明显,随病程进展病变加重,8wk与4wk相比,P<0.01,12wk与8wk相比,P<0.001。结论灌胃为一种简单可行的造模方法;PDGF可能在酒精性肝纤维化的发生发展中起重要作用,但详细机制有待进一步探讨。展开更多
基金supported by a grant from Catholic Universitary Center(Centro Universitario Cattolico)-Conferenza Episcopale Italiana,Rome,Italy(to FF)。
文摘Diabetes mellitus and associated chronic hyperglycemia enhance the risk of acute ischemic stroke and lead to worsened clinical outcome and increased mortality. However, post-stroke hyperglycemia is also present in a number of non-diabetic patients after acute ischemic stroke, presumably as a stress response. The aim of this review is to summarize the main effects of hyperglycemia when associated to ischemic injury in acute stroke patients, highlighting the clinical and neurological outcomes in these conditions and after the administration of the currently approved pharmacological treatment, i.e. insulin. The disappointing results of the clinical trials on insulin(including the hypoglycemic events) demand a change of strategy based on more focused therapies. Starting from the comprehensive evaluation of the physiopathological alterations occurring in the ischemic brain during hyperglycemic conditions, the effects of various classes of glucose-lowering drugs are reviewed, such as glucose-like peptide-1 receptor agonists, DPP-4 inhibitors and sodium glucose cotransporter 2 inhibitors, in the perspective of overcoming the up-to-date limitations and of evaluating the effectiveness of new potential therapeutic strategies.
文摘Osteoarthritis and psoriasis arthritis are two degenerative forms of arthritis that share similar yet also different manifestations at the histological,cellular,and clinical levels.Rheumatologists have marked them as two entirely distinct arthropathies.Given recent dis-coveries in disease initiation and progression,potential mechanisms,cellular signaling path-ways,and ongoing clinical therapeutics,there are now more opportunities for discovering osteoarthritis drugs.This review summarized the osteoarthritis and psoriasis arthritis signaling pathways,crosstalk between BMP,WNT,TGF-β,VEGF,TLR,and FGF signaling pathways,bio-markers,and anatomical pathologies.Through bench research,we demonstrated that regen-erative medicine is a promising alternative for treating osteoarthritis by highlighting significant scientific discoveries on entheses,multiple signaling blockers,and novel molecules such as immunoglobulin new antigen receptors targeted for potential drug evaluation.Furthermore,we offered valuable therapeutic approaches with a multidisciplinary strategy to treat patients with osteoarthritis or psoriasis arthritis in the coming future in the clinic.
文摘发育性髋关节发育不良(developmental dysplasia of the hip,DDH)是常见的儿童肢体畸形,早期筛查和诊断非常重要,延误治疗或治疗不当将导致严重后果。股骨头缺血性坏死(avascular necrosis,AVN)是DDH闭合复位后严重且常见的并发症,如何预防及避免AVN的发生一直困扰着小儿骨科医师。闭合复位前骨化核的存在似乎有助于降低AVN发生率,避免AVN的发生与DDH早诊断、早治疗关系密切。本文就骨化核与DDH闭合复位后AVN相关性的研究进展进行综述。
文摘Bland-White-Garland syndrome or ALCAPA is an abnormality of birth of the left coronary artery from the pulmonary artery. It is a diagnostic and therapeutic emergency because it is a curable cause of hypokinetic dilated heart disease in infants. We report through this clinical case, the fourth case of infantile ALCAPA diagnosed in Senegal in a 7-month-old infant. The symptomatology began around the age of 2 months, with a grumpy state associated with more marked crying and moaning during feedings and bowel movements. The mother reported hospitalization for a severe lung infection when she was 6 months old. The examination noted an infant in poor general condition, retarded growth and weight, and a 3/6th holosystolic murmur at the apex. Troponinemia was positive at 43.90 ng/L. The electrocardiogram showed Q waves on the lower side, a sub endocardial lesion on the upper side and a ST segment elevation in aVR. Doppler echocardiography showed dilated cardiomyopathy with a mean alteration of systolic function of the left ventricle at 37%, a mean mitral insufficiency and a strong suspicion of a birth anomaly of the left coronary artery. The CT scan confirmed the diagnosis of ALCAPA. Surgicalreimplantation of the left coronary artery at the aortic level was performed at 10 months of life with a favourable outcome at D50 postoperative.
文摘INTRODUCTIONIt is axiomatic that the most effective and soundlybased plan of treatment of any disorder is one aimedat the mechanism or mechanisms responsible for itsdevelopment.This basic notion,coupled withrecent reports in which,surprisingly there is atotal lack of reference to the probable involvementof autonomic-arc-reflexes in the
文摘AIM To investigate the secreting functions of saliva in patients with TCM Piyinxu (Spleen yin deficiency). METHODS According to the traditional Chinese medical diagnositic standard, 25 cases of Piyinxu (male 15, female 10, aged from 26~70, average 45 years) were observed and compared with 20 cases of Shenyinxu (Kidney yin deficiency) patients (male 11, female 9, aged from 35~75, average 50) and 30 normal persons (male 17, female 13, aged from 35~65, average 49). After acid stimulation, the secretion flow was measured, the saliva amylase and protein were surveyed using the automatic biochemical analyzer. Statistical analysis was carried out with Kruskal Wallis test and one way factorial ANOVA test. RESULTS In Piyinxu patients, the saliva′s secreting flow rate (0 27ml/min±0 016ml/min) and amylase per min (2134 13IU/min±343 51IU/min) was lower than that in normal subjects (0 46ml/min±0 027ml/min and 3501 63IU/min±1099 63IU/min, P <0 01) and higher than that in Shenyinxu group (0 13ml/min±0 051ml/min and 951 62IU/min±383 17IU/min, P <0 01). But there was no significant difference between each group in total salivary protein (Piyinxu group 3 07g/L±0 60g/L, Shenyinxu 3 01g/L±0 90g/L and control 2 94g/L±1 13g/L, P =0 869), amylase per volume and the ratio of the amylase to the protein ( P =0 173 and 0 436). CONCLUSION The secreting functions of saliva in Piyinxu patients are low.
文摘AIM To investigate the etiologic association of pancreas divisum (PD) with chronic pancreatitis and to clarify its pathogenesis. METHODS A PD canine model was established in 32 dogs. The dogs were randomly divided into 4 groups ( n =8). Group Ⅰ: The communicating branch between the dorsal and ventral pancreatic ducts was partly ligated. Group Ⅱa: The communicating branch was amputated and completely ligated. Group Ⅱb: The dorsal duct was amputated and ligated at 2mm distance to the minor papilla. Group Ⅲ: A sham operation without any amputation or ligation was performed. Before and after operation, the activities of serum phospholipase A2 (PLA2) and amylase (Ams) were assayed and the basal pressures of the ducts were measured when secretin was injected. Pancreatic ductography and the pathologic examination were made. RESULTS The activities of serum PLA2 and Ams in Group Ⅰ,Ⅱa and Ⅱb were significantly increased 5-80 days after operation. At sacrifice, the basal pressures of the ventral duct were significantly higher 30min-60min after provocation in Group Ⅰ, Ⅱa and Ⅱb. The pressures of the dorsal duct were significantly increased in Group Ⅱb but no difference in Group Ⅰ and Ⅱa. Under light microscopy the fibrosis of interlobus and periducts, the destruction of acini and infiltration of inflammatory cell in dorsal and ventral pancreas were found in Group Ⅱb. But in Group Ⅰ and Ⅱa, these findings were present only in ventral pancreas. The electron microscopy showed that in ventral pancreas of Groups Ⅰ and Ⅱa and the dorsal and ventral pancreas of Group Ⅱb, the rough endoplasmic reticulum of the acinar cells showed granules scaling, fusion and dilatation. The zymogen granules decreased and the mitochondria was swollen. CONCLUSION PD is one of etiologic factors in chronic pancreatitis. The pathogenesis is the functional obstruction of the minor papilla at the peak stage of secretion.
文摘目的为深入研究酒精性肝病的发病机制,提供一个简单可行的动物模型,并利用此模型检测血浆PDGF含量在酒精性肝病发生发展中的变化。方法本研究在平衡饮食的条件下,以400mL·L^(-1)乙醇,8g·kg^(-1)·d^(-1),日3次灌胃至4wk末,自5wk,以500 mL·L^(-1)乙醇,9g·kg^(-1)·d^(-1),日3次灌胃至8 wk末,自9 wk,以500mL·L^(-1)乙醇,10g·kg^(-1)·d^(-1)日3次灌胃至12wk末,诱导酒精性肝病大鼠动物模型,分别于4wk末、8wk末、12wk末观察肝脏病理学改变,并用生物活性法测定了对照组及实验组不同病理阶段血浆中血小板源性生长因子(PDGF)的含量。结果光镜显示对照组肝细胞以中央静脉为中心呈放射状排列,酒精摄入4wk末,肝细胞中重度脂肪变性,8wk末肝细胞变性坏死,炎性细胞浸润,Mallory染色可见胶原于中央静脉沉积增加,12wk末变性坏死及炎性细胞浸润明显,Mallory染色可见胶原自中央静脉向窦周隙伸展,呈现轻度肝纤维化改变,PDGF含量结果可见与同时期对照组相比,实验组PDGF含量(kU·L^(-1))均有显著增高,4,8,12wk分别为67±15 vs 31±18(P<0.05),130±30vs33±19(P<0.001),202±20 vs 36±6(P<0.001);实验组不同时期差异明显,随病程进展病变加重,8wk与4wk相比,P<0.01,12wk与8wk相比,P<0.001。结论灌胃为一种简单可行的造模方法;PDGF可能在酒精性肝纤维化的发生发展中起重要作用,但详细机制有待进一步探讨。