简介：Preventionoflatecomplicationsafterlargeendoscopicresectionisinefficientwithcurrentmethods.Endoscopicshielding,asasimpleandsafetechnique,hasbeenproposedtoimprovetheincidenceoftheseevents.Differentmethods,sheetsorhydrogels,haveshowedprovenefficacyinthepreventionoflatebleedingandperforation,aswellastheimprovementoftissuerepair,inexperimentalmodelsandinclinicalpractice.

简介：Acutepancreatitis(AP)isafrequentdiseasewithdegreesofincreasingseverityresponsibleforhighmorbidity.Despitecontinuousimprovementincare,mortalityremainssignificant.Becausehypovolemia,togetherwithmicrocirculatorydysfunctionleadtopooroutcome,fluidtherapyremainsacornerstoneofthesupportivetreatment.However,poorclinicalevidenceactuallysupporttheaggressivefluidtherapyrecommendedinrecentguidelinessinceavailabledataarecontroversial.Fluidmanagementremainsunclearandleadstocurrentheterogeneouspractice.DifferentstrategiesmayhelptoimprovefluidresuscitationinAP.Ononehand,integrationoffluidtherapyinaglobalhemodynamicresuscitationhasbeendemonstratedtoimproveoutcomeinsurgicalorsepticpatients.Tailoredfluidadministrationafterearlyidentificationofpatientswithhigh-riskofpooroutcomepresentinginadequatetissueoxygenationisamajorpartofthisstrategy.Ontheotherhand,newdecisionparametershavebeendevelopedrecentlytoimprovesafetyandefficiencyoffluidtherapyincriticallyillpatients.Inthisreview,weproposeapersonalizedstrategyintegratingthesenewconceptsintheearlyfluidmanagementofAP.ThisnewapproachpavesthewaytoawiderangeofclinicalstudiesinthefieldofAP.

简介：AIM:Toinvestigatethediagnosticaccuracyofthemeanplateletvolumeandplateletdistributionwidthinacuteappendicitis.METHODS:Thisretrospective,case-controlledstudycompared295patientswithacuteappendicitis(Group?Ⅰ),100patientswithotherintra-abdominalinfections(GroupⅡ),and100healthyindividuals(GroupⅢ)betweenJanuary2012andJanuary2013.Theage,gender,andwhitebloodcellcount,neutrophilpercentage,meanplateletvolume,andplateletdistributionwidthvaluesfrombloodsampleswerecomparedamongthegroups.StatisticalanalyseswereperformedusingSPSSforWindows21.0software.Inaddition,thesensitivity,specificity,positiveandnegativepredictivevaluesandlikelihoodratios,anddiagnosticaccuracywerecalculated.RESULTS:Themeanagesofpatientswere29.9±12.0yearsforGroup?Ⅰ,31.5±14.0yearsforGroupⅡ,and30.4±13.0yearsforGroupⅢ.Demographicfeaturessuchasageandgenderwerenotsignificantlydifferentamongthegroups.Whitebloodcellcount,neutrophilpercentageandplateletdistributionwidthweresignificantlyhigherinGroup?Ⅰ?comparedtogroupsⅡandⅢ(P<0.05).Diagnostically,thesensitivity,specificityanddiagnosticaccuracywere73.1%,94.0%,and78%forwhitebloodcellcount,70.0%,96.0%,and76.0%forneutrophilpercentage,29.5%,49.0%,and34.0%formeanplateletvolume,and97.1%,93.0%,and96.0%forplateletdistributionwidth,respectively.ThehighestdiagnosticaccuracydetectedwasforplateletdistributionwidthbetweenGroup?Ⅰ?andGroupⅢ(P<0.01).CONCLUSION:Plateletdistributionwidthanalysiscanbeusedfordiagnosisofacuteappendicitiswithoutrequiringadditionaltests,thusreducingthecostandlossoftime.

简介：INTRODUCTIONAmajorfunctionoftheintestinalepitheliumistocontroltheamountoffluidenteringintoandbeingabsorbedfromthelumen.Inhealthyconditions,netfluidmovementfollowsanabsorptivevector,althoughsignificantsecretionalsotakesplacetosubservedigestivefunction.Thus,the

简介：脱发areata是头发滤泡的疾病，与支持自体免疫的病原学的充分证据。脱发areata经常与象干癣和地衣planus那样的皮肤表明与调停免疫者的疾病被联系，或没有象自体免疫的甲状腺炎和自发的thrombocytopenic紫癜病那样的皮肤表明。Helicobacterpylori(H。pylori)感染在约50%世界人口是在场的并且包括自体免疫的甲状腺炎，自发的thrombocytopenic紫癜病，和干癣与许多调停免疫者的额外消化的混乱被联系了。有头皮和胡子的脱发areata的8瞬间历史的一个43年的老人的一个盒子被介绍。病人被一个皮肤学家正在对待并且有精神病学的支持，没有任何改进。他有消化不良的历史，脲呼吸测试证实了H。pylori感染。病人在H以后从脱发areata走进宽恕。pylori根除。如果如此的一个协会被为这个目的设计的流行病学的研究证实，新治疗学的选择能为这些病人是可得到的，特别在区域在哪儿有H的感染。pylori是高度流行的。

简介：Pancreaticcysticlesions(PCLs)areincreasinglybeingidentifiedbecauseofthewidespreaduseofhighresolutionabdominalimaging.Thesecystsencompassaspectrumfrommalignantdiseasetobenignlesions,andtherefore,accuratediagnosisiscrucialtodeterminethebestmanagementstrategy,eithersurgicalresectionorsurveillance.However,thecurrentstandardofdiagnosisisnotaccurateenoughduetolimitationsofimagingandtissuesamplingtechniques,whichentailtheriskofunnecessaryburdensomesurgeryforbenignlesionsormissedopportunitiesofprophylacticsurgeryforpotentiallymalignantPCLs.Inthelastdecade,endoscopicinnovationsbasedonendoscopicultrasonography(EUS)imaginghaveemerged,aimingtoovercomethepresentlimitations.ThesenewEUS-basedtechnologiesarecontrastharmonicEUS,needle-basedconfocalendomicroscopy,through-the-needlecystoscopyandthrough-theneedleintracysticbiopsy.Here,wepresentacomprehensiveandcriticalreviewoftheseemergingendoscopictoolsforthediagnosisofPCLs,withaspecialemphasisonfeasibility,safetyanddiagnosticperformance.

简介：瞄准：在试验性的老鼠在生物化学、组织病理学说的变化，氧化压力，和细菌的易位(BT)上调查allopurinol和高比重的氧(HBO)治疗的单个、联合的效果尖锐胰腺炎(AP)。方法：85只Sprague-Dawley老鼠在学习被包括。85只老鼠中的十五个被用作控制(假冒，组我)。AP在留下经由管内牛磺胆酸盐注入被导致七十只老鼠。幸存到尖锐引起坏死胰腺炎的正式就职的老鼠被使随机化进四个组。组II独自收到了saline，组IIIallopurinol，加HBO的组IVallopurinol和组VHBO。浆液淀粉酶层次，氧化压力参数，BT和组织病理学说的分数是坚定的。结果：浆液淀粉酶层次在与组II相比的组III，IV和V是更低的(974+/-110，384+/-40，851+/-56，和1664+/-234U/L，分别地P<0.05，为所有)。联合揭示的二种处理选择显著地降低median[25-75百分位数]组织病理学说的分数什么时候与单个政府相比(13[12.5-15]在allopurinol组，9.5[7-11.75]在HBO组，并且6[4.5-7.5]在联合的组，P<0.01)。氧化压力标记在与控制相比的所有处理组显著地更好。进胰和mes伤寒淋巴结的细菌的易位在与组II相比的组III，IV和V是更低的(54%，23%，50%对为到胰的易位的100%，并且62%，46%，58%对为到mes伤寒淋巴节点的易位的100%，分别地P<0.05为所有)。结论：当在试验性的老鼠AP独立管理了时，现在的学习证实HBO和allopurinol处理的利益。这些处理选择的联合看起来更有效地阻止胰腺的损害参数的前进。

简介：AIM:ToevaluatethecompletionrateanddiagnosticyieldofthePillCamSB2-exincomparisontothePillCamSB2.METHODS:Twohundredcasesusingthe8-hPillCamSB2wereretrospectivelycomparedto200casesusingthe12hPillCamSB2-exatatertiaryacademiccenter.Endoscopicallyplacedcapsuleswereexcludedfromthestudy.Demographicinformation,indicationsforcapsuleendoscopy,capsuletype,studylength,completionofexam,clinicallysignificantfindings,timestampofmostdistantfinding...

简介：瞄准：为了学习流行和风险因素，与人的免疫不全与三倍的感染联系了在一张城市的诊所人口的病毒(HIV)/hepatitisB(HBV)/hepatitisC病毒(HCV)。方法：5639个病人的回顾的图表评论在纽约城市里在圣卢凯斯鲁塞韦尔特医院HIV诊所(全面照顾的中心)列在后面，从1999年1月的美国到2007年5月。下列人口统计的特征被分析：年龄，性别，种族和HIV冒因素的风险。多重逻辑回归分析被执行在这些病毒的获得上评估人口统计的因素的影响。结果：HIV/HBV，HIV/HCV和HIV/HBV/HCV感染在252/5639(4.47%)被检测，1411/5639(25.02%)和89/5639(1.58%)病人分别地。HIV/HBV合作感染与男性被联系(或1.711；P=0.005)，黑色跑(或2.091；P<0.001)，人与\O性交人(MSM)(或1.747；P=0.001)，静脉内的药使用(IDU)(或0.114；P<0.001)，IDU和异性爱的活动(或0.247；P=0.018)，或未知(或1.984；P=0.004)。HIV/HCV合作感染与男性被联系(或1.241；P=0.011)，黑色跑(或0.788；P=0.036)，MSM(或0.565；P<0.001)，IDU(或8.956；P<0.001)，IDU和异性爱的活动(或9.106；P<0.001)，IDU和MSM(或9.179；P<0.001)，或输送(或3.224；P<0.001)。HIV/HBV/HCV合作感染与男性被联系(或2.156；P=0.015)，IDU(或6.345；P<0.001)，IDU和异性爱的活动(或9.731；P<0.001)，IDU和MSM(或9.228；P<0.001)，或未知(或4.219；P=0.007)。结论：我们的学习证明有HBV/HCV/HIV的合作感染显著地与IDU被联系。这些结果加亮需要加强教育和综合照顾的最佳的模型，特别地为有IDU的人口，到减少病毒的传播的风险。