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Gastroenterology in developing countries:Issues and advances

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World Journal of Gastroenterology 2009年第23期15卷 2839-2854页

作者： Kate L Mandeville Justus Krabshuis Nimzing Gwamzhi Ladep Chris JJ Mulder eamonn mm quigley Shahid A Khan Centre for Infectious Diseases Epidemiology Department of Primary Care and Population Sciences University College London Hampstead Campus Royal Free Hospital London NW3 2PF United Kingdom Highland Data Les Charleix 24390 Tourtoirac Dordogne France Department of Medicine University of Jos and Jos University Teaching Hospital Jos Plateau State P.M.B. 2076 Nigeria Department of Gastroenterology VU University Medical Center Amsterdam 1081 HV Holland World Gastroenterology Organisation and Department of Medicine National University of Ireland Cork University Hospital Clinical Sciences Building Wilton Cork Ireland Department of Hepatology and Gastro-enterology Faculty of Medicine Imperial College London St Mary's Campus London W2 1NY United Kingdom

Developing countries shoulder a considerable burden of gastroenterological disease. Infectious diseases in particular cause enormous morbidity and mortality. Diseases which afflict both western and developing countries are often seen in more florid forms in poorer countries. Innovative techniques continuously improve and update gastroenterological practice. However, advances in diagnosis and treatment which are commonplace in the West, have yet to reach many developing countries. Clinical guidelines, based on these advances and collated in resource-rich environments,lose their relevance outside these settings. In this two-part review, we first highlight the global burden of gastroenterological disease in three major areas: diarrhoeal diseases, hepatitis B, and Helicobacter pylori . Recent progress in their management is explored, with consideration of future solutions. The second part of the review focuses on the delivery of clinical services in developing countries. Inadequate numbers of healthcare workers hamper efforts to combat gastroenterological disease. Reasons for this shortage are examined, along with possibilities for increased specialist training. Endoscopy services, the mainstay of gastroenterology in the West, are in their infancy in many developing countries. The challenges faced by those setting up a service are illustrated by the example of a Nigerian endoscopy unit. Finally, we highlight the limited scope of many clinical guidelines produced in western countries. Guidelines which take account of resource limitations in the form of "cascades" are advocated in order to make these guidelines truly global. Recognition of the different working conditions facing practitioners worldwide is an important step towards narrowing the gap between gastroenterology in rich and poor countries.

关键词：发展中国家胃肠病传染性疾病预防措施

Microbiota-host interactions in irritable bowel syndrome: Epithelial barrier, immune regulation and brain-gut interactions

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World Journal of Gastroenterology 2014年第27期20卷 8859-8866页

作者： Niall P Hyland eamonn mm quigley Elizabeth Brint Alimentary Pharmabiotic Centre University College Cork 30 Cork Ireland Department of Pharmacology and Therapeutics University College Cork 30 Cork Ireland Houston Methodist Hospital Houston TX 77030 United States Department of Pathology University College Cork 30 Cork Ireland

Irritable bowel syndrome(IBS) is a common, sometimes debilitating, gastrointestinal disorder worldwide. While altered gut motility and sensation, as well as aberrant brain perception of visceral events, are thought to contribute to the genesis of symptoms in IBS, a search for an underlying aetiology has, to date, proven unsuccessful. Recently, attention has been focused on the microbiota as a possible factor in the pathogenesis of IBS. Prompted by a number of clinical observations, such as the recognition of the de novo development of IBS following enteric infections, as well as descriptions of changes in colonic bacterial populations in IBS and supported by clinical responses to interventions, such as antibiotics and probiotics, that modify the microbiota, various approaches have been taken to investigating the microbiota-host response in IBS, as well as in animal models thereof. From such studies a considerable body of evidence has accumulated to indicate the activation or upregulation of both factors involved in bacterial engagement with the host as well host defence mechanisms against bacteria. Alterations in gut barrier function, occurring in response, or in parallel, to changes in the microbiota, have also been widely described and can be seen to play a pivotal role in generating and sustaining host immune responses both within and beyond the gut. In this manner a plausible hypothesis, based on an altered microbiota and/or an aberrant host response, for the pathogenesis, of at least some instances of IBS, can be generated.

关键词： Microbiota Irritable bowel syndrome Tolllike recep

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高催乳素血症在临床方面的估价

国际妇产科学杂志 1982年第1期 26-28页

作者： quigley mm Haney AF 毛兰影

早在1954年就已知有些垂体肿瘤引起催乳素(PRL)分泌增加,但至1971年有了敏感的PRL放射免疫测定法后,才证明大部份垂体肿瘤合并高PRL血症。在这以前对多数垂体肿瘤,认为是“无功能的嫌色细胞腺瘤”,极少病例根据其临床表现,诊断为有内分... 详细信息

早在1954年就已知有些垂体肿瘤引起催乳素(PRL)分泌增加,但至1971年有了敏感的PRL放射免疫测定法后,才证明大部份垂体肿瘤合并高PRL血症。在这以前对多数垂体肿瘤,认为是“无功能的嫌色细胞腺瘤”,极少病例根据其临床表现,诊断为有内分泌功能,能分泌促肾上腺皮质素(AC-TH)或生长素(GH)的肿瘤。目前,只知道垂体前叶激素是由持续呈抑制状态的下丘脑控制。而这一机能减弱能使PRL分泌增加。垂体肿瘤引起的高PRL血症通过两个途径:第一肿瘤是由生乳细胞构成;第二下丘脑催乳素抑制因子(PIF)到达垂体的量减少,结果分泌增加。

关键词：垂体肿瘤血症患者血证 PRL 腺垂体垂体前叶估价蝶骨蝶鞍溢乳垂体微腺瘤

Effects of hydrological and climatic variables on cyanobacterial blooms in four large shallow lakes fed by the Yangtze River

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Environmental Science and Ecotechnology 2021年第1期5卷 1-9页

作者： Jian Huang Qiujin Xu Xixi Wang Hao Ji Edward J.quigley Mohamadali Sharbatmaleki Simeng Li Beidou Xi Biao Sun Caole Li California State Polytechnic University Pomona CAUSA Chinese Research Academy of Environmental Sciences BeijingChina Old Dominion University NorfolkVAUSA Inner Mongolia Agriculture University HohhotChina

Shallow lakes,one of the most widespread water bodies in the world,are easily shifted to a new trophic state due to external *** hydrologic conditions and climate change can cause cyanobacterial harmful algal blooms(CyanoHABs)in shallow lakes,which pose serious threats to ecological integrity and human *** study analyzed the effects of hydrologic and meteorological variables on cyanobacterial blooms in Yangtze-connected lakes(Lake Dongting and Poyang)and isolated lakes(Lake Chao and Tai).The results show that(i)chlorophyll-a(Chl-a)concentration tends to decrease exponentially with increasing relative lake level fluctuations(RLLF)and precipitation,but to increase linearly with increasing wind speed and air temperature;(ii)Chl-a concentrations in lakes were significantly higher when RLLFmm,wind speed>2.6 ms^(-1),or air temperature>17.8℃;(iii)the Chl-a concentration of Yangtze-isolated lakes was more significantly affected by water level amplitude,precipitation,wind speed and air temperature than the Yangtze-connected lakes;(iv)the RLLF and the ratio of wind speed to mean water depth could be innovative coupling factors to examine variation characteristics of Chl-a in shallow lakes with greater correlation than single factors.

关键词： Chlorophyll-a Eutrophication Relative lake level fluctuation Yangtze-connected lakes Yangtze-isolated lakes