学科分类
/ 1
9 个结果
  • 简介:Chronicpancreatitisisanongoingdiseasecharacterizedbypersistentinflammationofpancreatictissues.Withdiseaseprogression,patientswithchronicpancreatitismaydeveloptroublesomecomplicationsinadditiontoexocrineandendocrinepancreaticfunctionalloss.Amongthem,apseudoaneurysm,mainlyinducedbydigestiveenzymeerosionofvesselsinproximitytothepancreas,isarareandlife-threateningcomplicationifbleedingofthepseudoaneurysmoccurs.Atpresent,noprospectiverandomizedtrialshaveinvestigatedthetherapeuticstrategyforthisrarebutcriticalsituation.Theroleofarterialembolization,thetimingofsurgicalinterventionandevensurgicalproceduresarestillcontroversial.Inthisreview,wesuggestthatdynamicabdominalcomputedtomographyandangiographyshouldbeperformedfirsttolocalizethebleedersandtoevaluatetheassociatedcomplicationssuchaspseudocystformation,followedbyarterialembolizationtostopthebleedingandtoachieveearlystabilizationofthepatient’scondition.Withadvancesandimprovementsinendoscopicdevicesandtechniques,therapeuticendoscopyforpancreaticpseudocystsistechnicallyfeasible,safeandeffective.Surgicalinterventionisrecommendedforableedingpseudoaneurysminpatientswithchronicpancreatitiswhoareinanunstablecondition,forthoseinwhomarterialembolizationofthebleedingpseudoaneurysmfails,andwhenendoscopicmanagementofthepseudocystisunsuccessful.Ifableedingpseudoaneurysmislocatedoverthetailofthepancreas,resectionisapreferentialprocedure,whereasifthelesionissituatedovertheheadorbodyofthepancreas,relativelyconservativesurgicalproceduresarerecommended.

  • 标签: CHRONIC PANCREATITIS PSEUDOCYST PSEUDOANEURYSM ble
  • 简介:瞄准:为了学习敏感,特性和钡餐的费用有效性,直与在开发国家钠起源的长期的腹的疼痛地为病人用作一种屏蔽形式的结肠积气(BMFTP)列在后面。方法:出席肠胃病学单位的五十个病人,SMS医院,其临床的评估揭示了肠起源的长期的腹的疼痛,在学习被包括。在平淡的测试以后,BMFT,BMFTP,对比腹部,钡灌肠和结肠镜检查的提高的计算断层摄影术(CECT)被执行。敏感,特性和在小或大的肠损害的察觉的这些成像形式的费用有效性被比较。结果:从五十个病人,结构的病理在十被发现。当七与小肠参与独自或在联合有结肠的参与时,九从这十个病人有小肠参与。当检测小肠参与时,BMFTP的敏感与BMFT是与88.89%相比的100%(BMFTP与回盲肠检测了一个另外的病人参与)。为结肠的病理的察觉的BMFTP的敏感和特性是85.71%和95.35%(41/43)分别地。当他们的敏感是几乎可比较的时,多于BMFTP显著地用BMFT和钡灌肠费用的联合长期的腹的疼痛(肠起源)地屏蔽一个病人。结论:BMFTP应该在研究工作被包括在上面有钠起源的长期的腹的疼痛的病人,在此也多重的地点(小并且大肠)被怀疑参与或这个地点在临床的根据上是不清楚的。BMFTP是排除的一个节俭、快、舒适的过程对在病人的多数的结肠镜检查的需要。

  • 标签: 腹部疼痛 |
  • 简介:AIM:Toevaluatetheimpactofsociodemographic/clinicalfactorsonearlyvirologicalresponse(EVR)topegin-terferon/ribavirinforchronichepatitisC(CHC)inclinicalpractice.METHODS:Weconductedamulticenter,cross-sectional,observationalstudyinHepatologyUnitsof91Spanishhospitals.CHCpatientstreatedwithpeginterferonα-2aplusribavirinwereincluded.EVRwasdefinedasundetectablehepatitisCvirus(HCV)-ribonucleicacid(RNA)or≥2logHCV-RNAdecreaseafter12wkoftreatment.AbivariateanalysisofsociodemographicandclinicalvariablesassociatedwithEVRwascarriedout.IndependentfactorsassociatedwithanEVRwereanalyzedusingamultipleregressionanalysisthatincludedthefollowingbaselinedemographicandclinicalvariables:age(≤40yearsvs>40years),gender,race,educationallevel,maritalstatusandfamilystatus,weight,alcoholandtobaccoconsumption,sourceofHCVinfection,alanineaminotransferase(ALT)andaspartateaminotransferase(AST)levels,andgammaglutamyltranspeptidase(GGT)(≤85IU/mLvs>85IU/mL),serumferritin,serumHCV-RNAconcentration(<400000vs≥400000),genotype(1/4vs3/4),cirrhoticstatusandribavirindose(800/1000/1200mg/d).RESULTS:Atotalof1014patientswereincludedinthestudy.Meanageofthepatientswas44.3±9.8years,70%weremale,and97%wereCaucasian.ThemainsourcesofHCVinfectionwereintravenousdrugabuse(25%)andbloodtransfusion(23%).SeventyeightpercentwereinfectedwithHCVgenotype1/4(68%hadgenotype1)and22%withgenotypes2/3.TheHCV-RNAlevelwas>400000IU/mLin74%ofpatients.ThemeanALTandASTlevelswere88.4±69.7IU/mLand73.9±64.4IU/mL,respectively,andmeanGGTlevelwas82±91.6IU/mL.Themeanferritinlevelwas266±284.8μg/L.Only6.2%ofpatientspresentedwithcirrhosis.Allpatientsreceived180mgofpeginterferonα-2a.Themostfrequentlyusedribavirindoseswere1000mg/d(41%)and1200mg/d(41%).Theplannedtreatm

  • 标签: ANTIVIRAL therapy BASELINE FACTORS Early virological
  • 简介:瞄准:为了在病人调查胰岛素抵抗和糖尿病的临床的参数的流行,由长期的丙肝(CHC)或长期的肝炎B(CHB)影响了。方法:我们回顾地评估了经历了肝活体检视的852个连续病人(726CHC和126CHB)。我们记录了年龄,性别,中高音,类型2糖尿病或新陈代谢的症候群(MS),身体团索引(BMI),和明显的疾病持续时间(增加)。结果:年龄,增加,BMI,在有温和/中等的肝纤维变性的病人的MS和糖尿病的流行在CHC是显著地更高的。然而,脂肪变性的度和在肝活体检视评估的肝纤维变性没在CHC和CHB病人之间不同。在多变量分析,年龄,性别,BMI,中高音和糖尿病是为在CHC的肝纤维变性的独立风险因素,而仅仅年龄与在CHB的肝纤维变性有关。我们也评估了在重要脂肪变性之间的协会(>30%)并且年龄,性别,BMI,糖尿病,MS和肝纤维变性。糖尿病,BMI和肝纤维变性与脂肪变性>被联系30%在CHC,而仅仅年龄和BMI与在CHB的脂肪变性有关。结论:这些数据可以显示丙肝病毒感染是为胰岛素抵抗的一个风险因素。

  • 标签: 糖尿病 胰岛素 临床 抵抗力 肝炎
  • 简介:瞄准:估计临床,生物化学并且virological在长期的丙肝(CHC)的长期的结果有在加ribavirin的peginterferon(PEG-IFN)以后的持续virological回答(SVR)的病人联合治疗。方法:有在有PEG-IFN正ribavirin的治疗以后的SVR的一百和53个病人在一个单个西班牙的中心在5年的后续研究被包括,基于标准临床的实践。临床的回忆,生物化学的分析,丙肝病毒RNA和alpha-fetoprotein测量,ultrasonography和短暂elastography每年被执行。结果:153个病人的吝啬的后续经期是76??敦瑥吗?

  • 标签: 丙型肝炎病毒 利巴韦林 聚乙二醇 病毒学 干扰素 患者
  • 简介:AIM:ToinvestigateapathophysiologicalroleofcathepsinW(CatW),aputativethiol-dependentcysteineprotease,whichisspecificallyexpressedincytotoxiclymphocytes,indifferenttypesofchronicinflammationofthegastricmucosa.METHODS:GastricandduodenalbiopsiesofpatientswithHelicobacterpylori(Hpylori)-associatedactivegastritis(Hp,n=19),chemicallyinducedreactivegastritis(CG,n=17),autoimmuneatrophicgastritis(AIG,n=20),lymphocyticcorpusgastritis(LG,n=29),celiacdisease(CD,n=10),andcorrespondingcontrols(n=24)wereanalyzedbyimmunohistochemistryfortheexpressionofCatWandCD45.Furthermore,immunohistochemicaldoublestainingwithanti-CD3andanti-cathepsinwasperformedforthesamplesofAIG.RESULTS:MedianvaluesofCatW-expressingcellsamongCD45-positiveimmunecellswerebetween2%and6%fornormalgastricmucosa,CG,andLG,whereasthecorrespondingvaluewassignificantlyincreasedforAIG(24.7%,P<0.001)andsignificantlydecreasedforHP(0.7%,P<0.05).Doublestainingwithanti-CD3andantiCatWantibodiesrevealedthat>90%ofCatW-expressingcellsingastricmucosaofAIGwereTcells.DuodenalmucosahadsignificantlymoreCatW/CD45-positivecellsthannormalgastricmucosa(median:17.8%vs2%,P<0.01).ThecorrespondingproportionofCatW/CD45-positivecellswasdecreasedinCDcomparedtoduodenalmucosa(median:2.1%vs17.8%,P<0.05).CONCLUSION:TheoppositefindingsregardingthepresenceofCatW-positivecellsinAIG(increase)andCD(decrease)reflectsthedifferentcellularcompositionofimmunecellsinvolvedinthepathogenesisofthesediseases.

  • 标签: 组织蛋白酶 T细胞 自身免疫性萎缩性胃炎 慢性胃炎
  • 简介:ToinvestigatetheprotectiveeffectofdecoctionofliaoweiongastricmucosaofH.pyloriassociatedchronicatrophicgastritisinrats.TheH.pyloriassociatedchronicatrophicgastritismodelswereinducedwithsodiumdeoxycholate,sodiumsalicylate,ethanol,andculturebrothofH.pylori.ProtectiveeffectofdecoctionofliaoweiongastricmucosaofH.pyloriassociatedchronicatrophicgastritiswasobservedquantitatively.

  • 标签: 保护作用 H.PYLORI 胃黏膜 慢性萎缩性胃炎 老鼠 消化系统
  • 简介:瞄准:把在病人之间的标准肝炎B(HBV)种痘的反应与长期的丙肝作比较病毒(HCV)感染和健康个人。方法:这是未来的盒子控制研究。有长期的HCV感染和40健康控制的38个病人的一个总数被包括。种痘被20大杯recombinantHBsAg的注射在瞬间0,1和6点执行进三角肌肌肉。Anti-HBs集中是在最后剂量以后决定了3瞬间并且在二个组之间比较了。反应模式是被描绘(1)高反应当anti-HBs抗体效价是>时100IU/L,(2)低反应当效价是10-100IU/L时并且(3)没有反应当效价是<时10IU/L。结果:在耐心的组,有10/38(26.3%)非应答者,8/38(21.1%)低应答者并且20/38(52.6%)高应答者。在控制组的相应价值是2/40(5.0%),7/40(17.5%)和31/40(77.5%)分别地。反应模式在二个组之间是统计上不同的。在里面多变量分析,吸烟是重要confounder,当HCV感染与更低的抗体反应失去了它的重要关联时。结论:有长期的HCV感染的病人趋于与健康个人相比对HBV种痘微弱地作出回应,尽管这关联不是独立的根据多变量分析。

  • 标签: 乙型肝炎 病毒 疫苗 免疫原性