Forensic interrogation of diabetic endothelitis in cardiovascular diseases and clinical translation in heart failure

Diabetic heart disease(DHD)can be classified as a primary consequence from several pathophysiological manifestation of diabetes mellitus(DM)on cardiac tissues or secondarily in extracardiac tissues and is encountered as either primary or secondary complications of DM.Endothelitis is inflammation of the vascular endothelium and is likely to be seen in the majority of patients who start to manifest an end organ complication of DM in this case DHD.Diabetes is a leading cause for many cardiovascular syndromes and diseases including congestive heart failure(CHF)however much remains unknown about the transition from diagnosed DM to clinical state and the contribution of the various mechanical and counterregulatory systems in the manifested complaint.Diastolic heart failure or heart failure with preserved ejection fraction(DHF/HFpEF),accounts for half of all CHF presentations,has DM as a major contributor,however,there remain large gaps in clinical and pathophysiological understanding.This review aims to explore the microscopic aspects in diabetic endothelitis and provide a clinical link to with context to HFpEF.

标准·方案·指南--全科医疗对下肢静脉溃疡的管理指南

背景慢性下肢静脉溃疡是全科医疗中最常见的伤口,其管理既具有挑战性,又十分耗时。目的介绍包含TIME概念和A2BC2D方法的简短实用指南,帮助全科医生和护士对慢性下肢静脉溃疡患者开展基于循证医学的照护。讨论慢性溃疡的有效管理涉及对溃疡和患者的评估。管理的基本要求是采取适当的措施清除溃疡,选择合适的敷料以保持恰当的水分平衡,在对动脉循环进行评估后,应用渐进压力绷带以及解决患者关心的问题,例如疼痛和令人讨厌的伤口分泌物。结论遵循本文提出的简单、基于循证的方法,大多数慢性下肢静脉溃疡患者可以在全科诊所得到有效管理。

^18氟-氟脱氧葡萄糖．正电子发射断层显像在评估局灶性皮质发育不良所致难治性癫痫致痫区中的应用

我国目前有癫痫患者逾千万，其中30％的患者经过规范的药物治疗后不能满意地控制发作，发展为难治性癫痫。针对其病因学的研究发现，造成难治性癫痫的脑组织病变主要包括皮质发育不良和肿瘤两大类。局灶性皮质发育不良（focalcorticaldysplasia，FCD）是局限的大脑皮质发育畸形，越来越多的新皮质病灶被高分辨MRI发现，其术后病理均提示FCD的存在。然而不少FCD患者高分辨MRI仅表现为局灶性皮质增厚、灰质一白质交界不清，或轻微的白质高信号，这些微小改变很容易漏诊，而且约30％FCD（特别是I型FCD）患者的MRI表现是阴性的“。

乳腺密度告知:需要有利大于弊的证据为今后的筛查工作提供参考

乳腺密度告知现状乳腺密度是乳腺癌发生的众多独立危险因素之一1。乳房筛查发现,人群中40%~50%的女性普遍乳腺致密(非均匀致密或极端致密)2,这使其成为最常见的乳腺癌发生的高危因素之一。除此之外,致密乳腺会增加女性在乳房X线照片上漏诊乳腺癌的风险,这意味着对于参与筛查的人来说,会延迟在下一次定期乳房X线照片被诊断为乳腺癌的间隔时间3。这是因为钼靶对于致密性乳腺的敏感性较低4。